AJP Reports最新文献

{"title":"Prenatal Genetic Screening and Diagnostic Testing: Assessing Patients' Knowledge, Clinical Experiences, and Utilized Resources in Comparison to Provider's Perceptions.","authors":"Arlin Delgado,&nbsp;Jay Schulkin,&nbsp;Charles J Macri","doi":"10.1055/s-0041-1742236","DOIUrl":"https://doi.org/10.1055/s-0041-1742236","url":null,"abstract":"<p><p><b>Objective</b>  This survey study aimed to assess patient knowledge, clinical resources, and utilized resources about genetic screening and diagnostic testing. <b>Study Design</b>  A one-time anonymous paper survey was distributed to 500 patients at a major urban obstetrics and gynecology department, and an online survey was sent to 229 providers. Descriptive statistics and chi-squared analyses were performed. <b>Results</b>  In all, 466 of 500 patient surveys were completed, and 441 analyzed (88.2% response rate). Among providers, 66 of 229 (29.0% response rate) responded. Patients were on average 32 years old, 27 weeks pregnant, and most often reported a graduate degree level of education (47.4%). Over 75% of patients reported accurate knowledge of basic genetic statements. Patients reported that discussing screening and diagnostic testing with their provider was significantly associated with properly defining screening and diagnostic testing ( <i>p</i>  < 0.001). Less than 10% of patients reported providers distributing web/video links, books, or any other resource; however, patients most often independently accessed web links (40.1%). <b>Conclusion</b>  Our findings suggest a positive impact from patient and provider discussions in office on patient knowledge and understanding. Discrepancies between educational resources distributed in the clinic and individually accessed resources highlight possible areas of change. Future work should evaluate and implement differing resources to increase patient knowledge.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"12 1","pages":"e27-e32"},"PeriodicalIF":0.9,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/74/61/10-1055-s-0041-1742236.PMC8816620.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39905080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial Literacy and Physician Wellness: Can a Financial Curriculum Improve an Obstetrician/Gynecologist Resident and Fellow's Well-Being?","authors":"Chase R Cawyer,&nbsp;Christina Blanchard,&nbsp;Kenneth H Kim","doi":"10.1055/s-0041-1742268","DOIUrl":"https://doi.org/10.1055/s-0041-1742268","url":null,"abstract":"<p><p><b>Objective</b>  This study aimed to evaluate the effects of a financial literacy curriculum on resident and fellow's sense of well-being and financial stress. <b>Study Design</b>  This single institution pilot study prospectively enrolled obstetrician/gynecologist (OB/GYN) medical trainees (residents and fellows) to take part in a five-part personal financial literacy curriculum during the 2019 to 2020 academic year. Topics covered included the following: financial education and its relationship to personal well-being, overview of financial terms and principles, budgeting, debt planning, and investing and giving. Primary outcomes were the improvement in well-being as measured by the Expanded Well-Being Index (E-WBI) and financial stress as measured by the Financial Stress Scale-College Version (FSS-CV) survey. <b>Results</b>  Of the 35 residents and fellows who participated in the study, 21 (60%) completed the postintervention survey. After course completion, there was significant improvement in the individual's E-WBI ( <i>p</i>  < 0.05) and no significant improvement in their FSS-CV ( <i>p</i>  = 0.06). After completing the course, trainees agreed that financial literacy improved their sense of well-being ( <i>p</i>  = 0.018). <b>Conclusion</b>  Cultivating financial literacy is associated with an improvement in the sense of well-being in residents and fellows and should be considered for inclusion in other graduate medical education (GME) programs.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"12 1","pages":"e64-e68"},"PeriodicalIF":0.9,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/93/dc/10-1055-s-0041-1742268.PMC8816634.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39766916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Video Education on Skin-to-Skin Contact at the Time of Delivery: A Randomized Controlled Trial.","authors":"Catherine M Caponero,&nbsp;Dani G Zoorob,&nbsp;Victor Heh,&nbsp;Hind N Moussa","doi":"10.1055/s-0041-1741540","DOIUrl":"https://doi.org/10.1055/s-0041-1741540","url":null,"abstract":"<p><p><b>Objective</b>  The objective of this study was to measure the impact of video education at the time of admission for delivery on intent and participation in skin-to-skin contact (SSC) immediately after birth. <b>Methods</b>  This study was a randomized controlled trial of educational intervention in women ( <i>N</i>  = 240) of 18 years or older admitted in anticipation of normal spontaneous term delivery. Alternate patients were randomized into video ( <i>N</i>  = 120) and no video ( <i>N</i>  = 120) groups. Both groups received a survey about SSC. The video group watched an educational DVD and completed a postsurvey about SSC. <b>Results</b>  During the preintervention survey, 89.2% of those in the video group compared with 83.3% of those in the no video group indicated that they planned to use SSC ( <i>p</i>  = 0.396). After the video, 98.3% planned to do SSC after delivery ( <i>p</i>  < 0.001). However, only 59.8% started SSC within 5 minutes of delivery in the video group and only 49.4% started SSC within 5 minutes of delivery in the no video group ( <i>p</i>  = 0.17). <b>Conclusion</b>  Video education alters the intention and trends toward participation in SSC within 5 minutes of delivery. Despite the plans for SSC, however, there was no significant difference in rates between the two groups. These findings support that obstacles, other than prenatal education, may affect early SSC. <b>Key Points</b> Significant obstacles impact skin-to-skin rate.Video education alters skin-to-skin intent.Video education can improve skin-to-skin rate.Education can happen at the time of delivery.Video education can impact mothers and infants.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"12 1","pages":"e10-e16"},"PeriodicalIF":0.9,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9c/1b/10-1055-s-0041-1741540.PMC8816630.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39905078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemodynamic Assessment of Pregnant People with and without Obesity by Noninvasive Bioreactance: A Pilot Study.","authors":"Ernesto A Figueiro-Filho,&nbsp;Na T S Robinson,&nbsp;Jose Carvalho,&nbsp;Johannes Keunen,&nbsp;Monique Robinson,&nbsp;Cynthia Maxwell","doi":"10.1055/s-0041-1742270","DOIUrl":"https://doi.org/10.1055/s-0041-1742270","url":null,"abstract":"<p><p><b>Objective</b>  This study aimed to identify cardiovascular differences between pregnant people with and without obesity for trimester-specific changes in hemodynamic parameters using noninvasive cardiac output monitoring (NICOM). <b>Study Design</b>  This study is a pilot prospective comparative cohort between pregnant people with and without obesity. Hemodynamic assessment was performed with NICOM (12-14, 21-23, and 34-36 weeks) during pregnancy. <b>Results</b>  In first trimester, pregnant people with obesity had higher blood pressure, stroke volume (SV), total peripheral resistance index (TPRI), and cardiac output (CO). Pregnant people with obesity continued to have higher SV and cardiac index (second and third trimesters). During the first trimester, body mass index (BMI) positively correlated with SV, TPRI, and CO. Fat mass showed a strong correlation with TPRI. BMI positively correlated with CO during the second trimester and fat mass was positively associated with CO. During the third trimester, TPR negatively correlated with BMI and fat mass. <b>Conclusion</b>  Fat mass gain in the period between the first and second trimesters in addition to the hemodynamic changes due to obesity and pregnancy contribute to some degree of left ventricular diastolic dysfunction which was manifested by lower SVs. Future work should investigate the possible causative role of obesity in the cardiovascular changes identified in people with obesity.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"12 1","pages":"e69-e75"},"PeriodicalIF":0.9,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b0/c5/10-1055-s-0041-1742270.PMC8816622.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39766917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limitations of Gravimetric Quantitative Blood Loss during Cesarean Delivery.","authors":"Robert L Thurer,&nbsp;Sahar Doctorvaladan,&nbsp;Brendan Carvalho,&nbsp;Andrea T Jelks","doi":"10.1055/s-0041-1742267","DOIUrl":"https://doi.org/10.1055/s-0041-1742267","url":null,"abstract":"<p><p><b>Objective</b>  This study examined the accuracy, sources of error, and limitations of gravimetric quantification of blood loss (QBL) during cesarean delivery. <b>Study Design</b>  Blood loss determined by assays of the hemoglobin content on surgical sponges and in suction canisters was compared with QBL in 50 parturients. <b>Results</b>  QBL was moderately correlated to the actual blood loss ( <i>r</i>  = 0.564; <i>p</i>  < 0.001). Compared with the reference assay, QBL overestimated blood loss for 44 patients (88%). QBL deviated from the assayed blood loss by more than 250 mL in 34 patients (68%) and by more than 500 mL in 16 cases (32%). Assayed blood loss was more than 1,000 mL in four patients. For three of these patients, QBL was more than 1,000 mL (sensitivity = 75%). QBL was more than 1,000 mL in 12 patients. While three of these had an assayed blood loss of more than 1,000 mL, 9 of the 46 patients with blood losses of less than 1,000 mL by the assay (20%) were incorrectly identified as having postpartum hemorrhage by QBL (false positives). The specificity of quantitative QBL for detection of blood loss more than or equal to 1,000 mL was 80.4%. <b>Conclusion</b>  QBL was only moderately correlated with the reference assay. While overestimation was more common than underestimation, both occurred. Moreover, QBL was particularly inaccurate when substantial bleeding occurred. <b>Key Points</b> QBL is inaccurate in cesarean delivery.QBL deviated from the assay result by more than 500 mL in 32% of cases.QBL sensitivity and specificity for hemorrhage is 75.0% (95% confidence interval [CI]: 0.19-0.93) and 80.4% (95% CI: 0.69-0.92), respectively.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"12 1","pages":"e36-e40"},"PeriodicalIF":0.9,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9e/83/10-1055-s-0041-1742267.PMC8816625.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39905082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the Degree of Maternal Fever in the Setting of Chorioamnionitis Lead to Adverse Neonatal Outcomes?","authors":"Megan S Varvoutis,&nbsp;Azza E Abdalla,&nbsp;Sarah K Dotters-Katz","doi":"10.1055/s-0041-1742269","DOIUrl":"https://doi.org/10.1055/s-0041-1742269","url":null,"abstract":"<p><p><b>Objective</b>  The effect of the degree of maternal fever in the setting of chorioamnionitis on neonatal morbidity is unclear. The objective of this study is to assess the association between high maternal fevers (≥ 39°C) on neonatal morbidity. <b>Study Design</b>  Secondary analysis of Maternal-Fetal Medicine Units (MFMU) Cesarean Registry data obtained from 1999 to 2002 among singleton gestations with chorioamnionitis. Women with a temperature less than 39°C (low fever) compared with those with greater than or equal to 39°C (high fever). Primary outcome was a composite of adverse neonatal outcomes such as death, sepsis, necrotizing enterocolitis, grade-3 or -4 intraventricular hemorrhage, seizure within 24 hours of delivery, intubation within 24 hours of delivery, and requiring cardiopulmonary resuscitation. Demographic characteristics compared using Fisher's exact and Wilcoxon's rank-sum test as appropriate. Multivariate logistic regression analysis with performed to control for cofounders. Stratified analysis also performed to assess outcomes in term infants. <b>Results</b>  Of 1,313 included women, 1,200 (91.3%) were in the low fever group and 113 (8.7%) were in the high fever group. Women in the high fever group were more likely to be African American and group B <i>Streptococcus</i> positive. No difference in primary outcome was noted between the groups (38.9% high fever vs. 35.8% low fever, <i>p</i>  = 0.54). High maternal fever was associated with increased risk of NICU admission (48.1 vs. 50.4%, <i>p</i>  = 0.02). When controlling for African American race, preterm birth, and delivery route, patients with high fever were not more likely to have adverse neonatal outcomes (adjusted odds ratio [aOR] = 1.28, 95% confidence interval [CI]: 0.84, 1.98). In the analysis limited to term infants, when controlling for confounders, high fever, similarly, was not associated with increased odds of adverse neonatal outcomes (aOR = 1.59, 95% CI: 0.96, 2.65). <b>Conclusion</b>  The degree of maternal fever does not appear to be associated with an increased likelihood of adverse neonatal outcomes. Better understanding maternal factors that affect neonatal morbidity in the setting of chorioamnionitis is critical. <b>Key Points</b> High maternal fever in the setting of chorioamnionitis does not appear to have an increased likelihood of adverse neonatal outcomes.It is important to identify factors that may increase the risk of adverse outcomes such as early onset sepsis.Maternal fever may not be a strong indicator for neonatal outcomes and antibiotic protocols.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"12 1","pages":"e58-e63"},"PeriodicalIF":0.9,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ae/4e/10-1055-s-0041-1742269.PMC8816624.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39905085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19-Associated Coagulopathy in the Peripartum Setting: A Case Report.","authors":"Ashley Allen,&nbsp;Christine Hoang,&nbsp;Roopina Sangha","doi":"10.1055/s-0041-1742237","DOIUrl":"https://doi.org/10.1055/s-0041-1742237","url":null,"abstract":"<p><p>Sepsis-induced coagulopathy (SIC) scoring and D-dimer can be used to recognize COVID-19-induced coagulopathy, but the utility of these is largely unknown in the peripartum setting and leaves anticoagulation guidance unclear. We present the case of a critically ill postpartum patient with COVID-19 infection. This patient presented with clinical signs of COVID-19 infection and developed acute respiratory failure requiring invasive mechanical ventilation and subsequent cesarean delivery at 34 weeks. She initially improved postoperatively but deteriorated after postoperative day 5. She was found to have a very elevated D-dimer of 58 μg/mL and anticoagulation was escalated to full dosing. She required prolonged mechanical ventilation and deceased after developing gram-positive cocci bacteremia. This case demonstrates that recognition and management of COVID-19-associated coagulopathy can be confusing in the peripartum period and studies are needed to validate D-dimer and SIC scoring in this population of patients.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"12 1","pages":"e33-e35"},"PeriodicalIF":0.9,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7a/7a/10-1055-s-0041-1742237.PMC8816627.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39905081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preconception Counseling: Identifying Ways to Improve Services.","authors":"Khyla Burrows,&nbsp;Jeanelle Sheeder,&nbsp;Virginia Lijewski,&nbsp;Teresa Harper","doi":"10.1055/s-0041-1742272","DOIUrl":"https://doi.org/10.1055/s-0041-1742272","url":null,"abstract":"<p><p><b>Objective</b>  The aim of this retrospective study was to evaluate the maternal conditions for which preconception services are provided and the routine services and recommendations offered through the Maternal Fetal Medicine group at the University of Colorado (CU). The study sought to determine how services and recommendations differ by maternal condition, demographics, and reproductive health history. <b>Materials and Methods</b>  Charts of patients who received preconception counseling through the CU MFM department during 2018 were reviewed to evaluate maternal conditions and the type of counseling patients received. Patients were grouped by their referral reason and subsequently by counseling recommendations to either proceed with immediate conception, defer immediate conception pending completion of further recommendations or to not conceive. <b>Results</b>  Of the fifty-nine patients referred to preconception counseling, 52% ( <i>n</i> = 31) of the women were referred for maternal disease, 40% ( <i>n</i> = 24) for infertility, 32% ( <i>n</i> = 19) for previous poor obstetric outcomes, 30% ( <i>n</i> = 18) for advanced maternal age and finally, 15% ( <i>n</i> = 9) for gynecologic anatomic abnormalities. <b>Conclusion</b>  During the initial evaluation, 58% ( <i>n</i> = 34) of patients were determined to have no concern for immediate conception while 7% ( <i>n</i> = 4) were ultimately advised to not conceive. Using this data, we identified areas of preconception counseling that standardization will improve by ensuring patients receive comparable services and advice.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"12 1","pages":"e49-e57"},"PeriodicalIF":0.9,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/28/d5/10-1055-s-0041-1742272.PMC8816632.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39905084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bedside Ultrasonography in Evaluating Mediastinum Leakage in an Extremely-Low-Birth-Weight Infant with Esophageal Perforation.","authors":"Mitsuhiro Haga,&nbsp;Yumiko Sato,&nbsp;Tomo Kakihara,&nbsp;Wakako Sumiya,&nbsp;Masayuki Kanno,&nbsp;Tetsuya Ishimaru,&nbsp;Masaki Shimizu,&nbsp;Hiroshi Kawashima","doi":"10.1055/s-0041-1741538","DOIUrl":"https://doi.org/10.1055/s-0041-1741538","url":null,"abstract":"<p><p>Esophageal perforation in premature infants is a life-threatening condition that requires prompt treatment. Contrast-enhanced computed tomography (CECT) is recommended for diagnosis. However, it is difficult to obtain CECT images in premature infants because of their unstable conditions. We encountered a case of esophageal perforation in an extremely-low-birth-weight female infant. Bedside ultrasonography was useful in the diagnosis and follow-up evaluation of leakage in the mediastinum. Ultrasonography can be a useful modality for the evaluation of perforation of the lower part of the esophagus in premature infants.</p>","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"12 1","pages":"e76-e79"},"PeriodicalIF":0.9,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b0/fc/10-1055-s-0041-1741538.PMC8816637.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39766918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transvaginal Sonographic Assessment Following Cervical Pessary Placement for Preterm Birth Prevention.","authors":"William Schnettler,&nbsp;Shwetha Manoharan,&nbsp;Kate Smith","doi":"10.1055/s-0041-1742273","DOIUrl":"https://doi.org/10.1055/s-0041-1742273","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background&lt;/b&gt;  Transvaginal sonographic cervical length assessment identifies pregnant women at risk for preterm birth, and the subsequent placement of a cervical pessary may reduce this risk. The mechanism of action remains uncertain, and postplacement transvaginal sonography may provide further insight into the controversial efficacy of this therapy. &lt;b&gt;Objective&lt;/b&gt;  To identify any pre- or postplacement sonographic findings associated with preterm delivery following cervical pessary insertion among at-risk women. &lt;b&gt;Materials and Methods&lt;/b&gt;  This retrospective cohort study utilized electronic medical record and imaging review of all women identified within a large tertiary care health system having undergone cervical pessary placement for preterm birth risk reduction and subsequently delivered between January 2013 (the adoption of this therapeutic option in our system) and March 2017. Indications for cervical pessary placement were guided by maternal-fetal medicine consultation and required a functional cervical length measurement on transvaginal sonography of 25 mm or less. Criteria for initial transvaginal cervical assessment included obstetric history, multiple gestation, and current concern on transabdominal imaging for cervical shortening. All pre- and postplacement transvaginal sonographic measurements were determined for study purposes by re-review of each patient's images by a single author blinded to outcome. &lt;b&gt;Results&lt;/b&gt;  A total of 88 women were identified as having undergone cervical pessary placement for preterm birth prevention, and 52 yielded complete delivery and imaging data for inclusion. As expected, this was a high-risk population with 51.9% carrying multiple gestations, 32.7% with a history of prior preterm birth, and 11.6% with a history of cervical conization. Although previously hypothesized to represent the mechanism of action, neither the change in uterocervical or intracervical angle was associated with gestational age at delivery. Alternatively, preplacement imaging measurements of cervical funneling, anterior cervical length, and cervical diameter were significantly associated with appropriate pessary placement and decreased preterm birth. Forty-two subjects (80.8%) demonstrated both the anterior and posterior aspects of the cervix within the pessary (appropriate placement) and 95.2% of these subjects demonstrated cervical funneling on initial imaging compared with 25% of those with inappropriate placement ( &lt;i&gt;p&lt;/i&gt;  = 0.002). Anterior cervical length less than 20 mm and cervical diameter less than 33 mm were associated with preterm delivery less than 28 weeks (16.7 vs. 0%, &lt;i&gt;p&lt;/i&gt;  = 0.039), and anterior cervical length less than 20 mm was associated with preterm delivery less than 32 weeks (41.7 vs. 10.7%, &lt;i&gt;p&lt;/i&gt;  = 0.025). Cervical diameter less than 33 mm correlated with an \"inappropriately placed\" pessary among 83.3% in comparison to 48.7% ( &lt;i&gt;p&lt;/i&gt;  = 0.048) of women with a cervical diamete","PeriodicalId":7645,"journal":{"name":"AJP Reports","volume":"12 1","pages":"e80-e88"},"PeriodicalIF":0.9,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/47/59/10-1055-s-0041-1742273.PMC8816641.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39766919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}