Abstract:
:The objective of this paper is to determine whether acyclovir suppression provides a greater cost savings over no medical therapy in the management of recurrent genital herpes (HSV) in pregnancy. Estimates of the risk of HSV recurrence and cesarean delivery rates in acyclovir-treated and -untreated patients and frequency of neonatal acyclovir treatment were derived from literature reviews, prospective surveillance, and practices at our institution. Estimates of costs were derived from average hospital and outpatient clinic charges at our institution. Calculations were run separately for four different groups of patients: women whose first diagnosis of genital herpes occurred during the pregnancy, women whose diagnosis antedated pregnancy and who had infrequent recurrences, women whose diagnosis antedated pregnancy and had frequent recurrences, and all women with a history of genital herpes regardless of timing of diagnosis or frequency of recurrences. Suppressive acyclovir treatment of all term pregnant women with a history of genital herpes resulted in an estimated savings of $183.00 per patient or $36,600,000 per year. Women with their first episode of herpes diagnosed during pregnancy or with frequent recurrences benefitted even more, achieving a savings of $455.00 and $391.00 per patient, respectively. Assuming that prenatal acyclovir treatment is safe for the fetus, utilizing this management for all patients with recurrent HSV in pregnancy could immediately save $183 per patient. On a national level, this translates to $36,600,000 per year just in reduced obstetrical costs. If indirect costs associated with cesarean deliveries had been included in these calculations, the estimated savings would be even more substantial.
journal_name
Am J Perinatoljournal_title
American journal of perinatologyauthors
Scott LL,Alexander Jdoi
10.1055/s-2007-993900subject
Has Abstractpub_date
1998-01-01 00:00:00pages
57-62issue
1eissn
0735-1631issn
1098-8785journal_volume
15pub_type
杂志文章abstract:OBJECTIVE:To evaluate the association between adequacy of prenatal care utilization and risk of fetal and neonatal mortality and adverse outcomes. METHODS:We conducted a population-based cohort study using the Center for Disease Control and Prevention's Linked Birth-Infant Death and Fetal Death data on all deliveries ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0032-1316439
更新日期:2012-11-01 00:00:00
abstract::The purpose of this study was to evaluate the feasibility of the use oral ibuprofen suspension (OIS) in the treatment of patent ductus arteriosus (PDA) in premature infants. Premature infants (= 35 weeks) age 2 to 7 days who suffered from respiratory distress and had been diagnosed with PDA were included in this stu...
journal_title:American journal of perinatology
pub_type: 杂志文章,随机对照试验
doi:10.1055/s-2007-976550
更新日期:2007-05-01 00:00:00
abstract::The Diabetes in Pregnancy Study Group of North America (DPSG-NA) was founded in 1997 in San Antonio, Texas, out of the recognition that the field of maternal-fetal medicine should support and conduct research to address the specialized needs of pregnant women with type 1, type 2, or gestational diabetes mellitus. Sinc...
journal_title:American journal of perinatology
pub_type: 历史文章,杂志文章
doi:10.1055/s-0036-1585082
更新日期:2016-11-01 00:00:00
abstract::We report about two newborns with sudden onset of inability of mechanical ventilation due to transient chest wall rigidity after fentanyl i.v. bolus of 2 and 4 microg/kg, respectively, resulting in severe hypoxemia and secondary bradycardia. A third case developed a rigidity of the tongue after fentanyl bolus, which c...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2000-7289
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVE:Our objective was to evaluate the efficacy of perioperative multimodal pain management in reducing opioid use after elective cesarean delivery (CD). STUDY DESIGN:A single-center, double-blinded, placebo-controlled randomized trial of women undergoing elective CD. Participants were allocated 1:1 to receive th...
journal_title:American journal of perinatology
pub_type: 杂志文章,随机对照试验
doi:10.1055/s-0039-1681096
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVE:This article identifies the prevalence and associated factors of hypophosphatemia (HP) in very low birth weight (VLBW) infants in the first week of life. STUDY DESIGN:Prospective exploratory cohort study of 106 consecutive VLBW infants admitted to neonatal intensive care at Foothills Hospital, Calgary, Canad...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0039-1677713
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:To determine the risk of gestational diabetes mellitus (GDM) and insulin resistance (IR) in obesity defined by body mass index (BMI), waist-to-hip ratio (WHR), or both combined. METHODS:Secondary analysis of a randomized multicenter trial of antioxidant supplementation versus placebo in nulliparous low-risk ...
journal_title:American journal of perinatology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1055/s-0035-1562928
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:To determine if increasing predicted risk of cesarean was associated with longer labor length and increased morbidity among women undergoing induction with an unfavorable cervix. STUDY DESIGN:Using a publically available database, we evaluated whether a previously validated prediction model for cesarean deli...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1675625
更新日期:2019-05-01 00:00:00
abstract::Infants born from mothers with antiphospholipid antibody (aPL) -positive autoimmune disease were prospectively evaluated for anticardiolipin and anti-beta2 glycoprotein I antibodies (group 1) and for growth and neurological development. The results were compared with those obtained from two age-matched control groups ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2006-939533
更新日期:2006-05-01 00:00:00
abstract::Neonatal alloimmune thrombocytopenia (NAIT) is the most common cause of severe thrombocytopenia in an otherwise healthy newborn. The most serious complication is intracranial hemorrhage, which can occur either in the fetus or the newborn. Despite the known serious sequelae, both antenatal management and neonatal treat...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-0030-1263296
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:We aim to quantify the impact of obesity on maternal intensive care unit (ICU) admission. MATERIALS AND METHODS:This is a population-based, retrospective cohort study of Ohio live births from 2006 to 2012. The primary outcome was maternal ICU admission. The primary exposure was maternal body mass index (BMI)...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1660460
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE: Delayed maturation of auditory brainstem pathway in neonates admitted to the neonatal intensive care unit (NICU) may lead to misdiagnosis of children with normal peripheral hearing and inappropriate use of amplification devices. The aim of this study is to determine the pattern of auditory brain stem respons...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1709467
更新日期:2020-04-10 00:00:00
abstract::We studied 16 women, at 32 weeks' or more gestation who required magnesium sulfate (MgSO4) therapy for preterm labor or preeclampsia. A 60-minute Doppler fetal heart rate (FHR) tracing, analyzed by the Oxford Sonicaid System 8000, was obtained for 1 hour before and 2 hours after each patient received intravenous MgSO4...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994468
更新日期:1995-07-01 00:00:00
abstract::The estimation of plasma bilirubin concentration in neonates, using a transcutaneous, noninvasive jaundice meter, is significantly affected by many factors, such as gestational age, birthweight, phototherapy, and skin pigmentation. In an attempt to minimize the influence of skin color and hence circumvent the need for...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2008-1040751
更新日期:1994-05-01 00:00:00
abstract:OBJECTIVE: Women with placenta accreta spectrum (PAS) having an unplanned delivery may have worse outcome compared with women with a planned delivery. The primary objective of this study was to compare severe maternal morbidity among women with PAS who had a planned scheduled delivery versus an unplanned delivery. Seco...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1714676
更新日期:2020-07-23 00:00:00
abstract:OBJECTIVE:This article assesses the degree of variability in the current practice of skin antiseptics used in Canadian neonatal intensive care units (NICUs) and different experiences related to each antiseptic used. METHODS:An anonymous survey was distributed to a clinical representative of each of the 124 Canadian le...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1661406
更新日期:2019-01-01 00:00:00
abstract::Fetal exposure to infection and inflammation can result in accelerated lung maturation and simultaneously altered lung development. This alteration is characterized by reduced alveolar and vascular formation that is one of the hallmarks of the changes observed in animal models and in infants with bronchopulmonary dysp...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1714347
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to estimate the contemporary national rate of severe maternal morbidity (SMM) and its associated hospital cost during delivery hospitalization. STUDY DESIGN:We conducted a retrospective study identifying all delivery hospitalizations in the United States between 2011 and 2012....
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1649481
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVE:Fetal tachyarrhythmias complicate 0.5% of pregnancies, with high morbidity and mortality. We hypothesized that maternal factors may predispose to fetal supraventricular tachycardia (SVT). STUDY DESIGN:We reviewed medical records of all 124 mothers who presented to the Vanderbilt Fetal Cardiology Clinic from ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0035-1552942
更新日期:2015-11-01 00:00:00
abstract::The objective of this paper is to determine if phenobarbital exposure during pregnancy affects developmental outcome at age 2 years. Between 1991 and 1994, 401 pregnant patients at risk for delivery prior to 34 weeks' gestation were invited to participate; 48 mothers declined entry. Before delivery, pharmacy randomize...
journal_title:American journal of perinatology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1055/s-2007-993836
更新日期:1999-01-01 00:00:00
abstract::As new information about coronavirus disease 2019 (COVID-19) is rapidly discovered, clinicians are better equipped to make informed decisions for their patients. While current research suggests COVID-19 viral antigen is not found in vaginal secretions, its detectability in the female lower genital tract may have clini...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1713665
更新日期:2020-09-01 00:00:00
abstract::Chorioamnionitis has generally been thought to be a contraindication to attempting a delayed interval delivery in a multiple gestation. We present a twin gestation in which a delay of 88 days between the birth of the two infants occurred. Chorioamnionitis observed immediately after the delivery of Twin A was successfu...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-993962
更新日期:1998-06-01 00:00:00
abstract::The combination of multicystic kidney and crossed ectopia is very rare. In most of the affected children, diagnosis has been made postnatally by ultrasonographic examination to evaluate a palpated abdominal mass. We describe the third male newborn reported in the literature with a prenatally diagnosed crossed ectopic ...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-2007-994073
更新日期:1998-08-01 00:00:00
abstract::A 27-year-old primigravida women was referred for ultrasound studies at 32 weeks' gestation because of the suspicion of fetal ventriculomegaly. Sonographic examination of the fetal brain found a marked shift of the midline, with enlarged left hemisphere and ipsilateral occipital horn, and abnormal convolutions. A 3500...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999330
更新日期:1991-01-01 00:00:00
abstract::We investigated body mass index (BMI) and weight gain among pregnant women (ages 14 to 25) and assessed the relationship of BMI and weight gain on birth outcomes. We performed a secondary analysis of 841 women enrolled in a randomized controlled trial receiving prenatal care in two university-affiliated clinics. Almos...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0028-1110088
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:This study assessed the impact of a nurse simulation training program on perception of kangaroo mother care (KMC) value and transfer skill competency. STUDY DESIGN:An 8-item Likert scale skill survey tool and a 24-item Likert developmental care survey tool were used in a prospective cohort study to analyze p...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0034-1371359
更新日期:2014-11-01 00:00:00
abstract::We compared lymphocyte subsets and cytokine responses to bacteria among term, preterm infants, and adults. Lymphocyte subset percentages in cord blood (22 preterm, 27 term neonates) and peripheral blood from 21 adults and cytokine/chemokine interleukin (IL)-6, IL-8, IL-10, IL-12, interferon gamma (IFN gamma) responses...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0029-1220788
更新日期:2009-10-01 00:00:00
abstract::Although cesarean section is one of the most ancient surgical procedures, the origin of its name remains obscure. The term, however, did not originate because of the birth of the Roman Emperor Julius Caesar through this route. In fact, historians are certain that Julius Caesar was not delivered by the dangerous cesare...
journal_title:American journal of perinatology
pub_type: 历史文章,杂志文章
doi:10.1055/s-2007-986693
更新日期:2007-11-01 00:00:00
abstract::The presence of the maternal warm antibody in pregnancy should not be ignored. As there is risk of both maternal and fetal anemia, both patients need to be followed for the development of such. Serial complete blood counts in the mother and treatment if significant fetal anemia develops should be considered. Serial am...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994196
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVE:Recent guidelines for neonatal cardiopulmonary resuscitation emphasize the importance of adequate ventilation. In cases of failed resuscitation with positive pressure ventilation, tracheal intubation and chest compressions are recommended. The present study compared the utility of the Miller laryngoscope (Mil...
journal_title:American journal of perinatology
pub_type: 杂志文章,随机对照试验
doi:10.1055/s-0034-1395482
更新日期:2015-07-01 00:00:00