Abstract:
OBJECTIVES:To evaluate the statewide experience in mode of delivery for pregnancies complicated by stillbirth by annual delivery volume and presence of graduate medical education programs. METHODS:This is a descriptive study of all stillbirths without known congenital anomalies or aneuploidy born in our state from July 1, 2015 to June 30, 2019. Stillbirths were ascertained by the State Reproductive Health Monitoring System, a population-based surveillance system. Stillbirths were identified by the State Reproductive Health Monitoring System from medical facilities and fetal death certificates; trained staff abstracted records. All of the stillbirths with a gestational age of >20 weeks or a birth weight of >500 g if birth weight was unknown and without congenital anomalies or aneuploidy were eligible for this study. RESULTS:There were 861 stillbirths from July 2015 through June 2019, 75 (8.7%) of which were delivered by cesarean section. Low-volume hospitals (<1000 deliveries) experienced a higher proportion of their stillbirths delivered by cesarean compared with high-volume hospitals (>1000 deliveries; 13.4% vs 5.5%; P < 0.0001). Before adjusting for maternal characteristics, stillbirths delivered at high-volume hospitals had a 59% lower risk of delivery by cesarean section compared with those delivered at low-volume hospitals (relative risk [RR] 0.41, 95% confidence interval 0.20-0.86, P = 0.02). The cesarean cohort had a higher proportion of Black mothers (44% vs 31.3%, P = 0.025), greater parity (P < 0.0001), and greater gravidity (P < 0.0001) compared with the vaginal group. The gestational age at delivery for stillbirths delivered by cesarean was much higher compared with those who were delivered vaginally (34.8 weeks vs 28.6 weeks; P < 0.0001). The RR of the cesarean delivery of a stillbirth at teaching institutions compared with nonteaching institutions was significantly reduced (RR 0.45, 95% confidence interval 0.28-0.73, P = 0.0011). CONCLUSIONS:Annual hospital delivery volumes and residency teaching programs in obstetrics influence the mode of delivery in the management of stillbirth. Advancing gestational age, Black race, and parity are associated with an increased risk of cesarean delivery after stillbirth.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Ramseyer AM,Whittington JR,Magann EF,Warford B,Ounpraseuth S,Nembhard WNdoi
10.14423/SMJ.0000000000001180subject
Has Abstractpub_date
2020-12-01 00:00:00pages
623-628issue
12eissn
0038-4348issn
1541-8243pii
SMJ50868journal_volume
113pub_type
杂志文章abstract::Endocrine metabolic emergencies are common clinical entities seen by most health care professionals in acute care medicine. Except for cardiopulmonary arrest, few situations require such rapid institution of immediate drug therapy to reverse life-threatening metabolic imbalances. To safely guide patients through these...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-198402000-00021
更新日期:1984-02-01 00:00:00
abstract::Considerable controversy exists with regard to therapeutic efficacy of plasmapheresis in the immune-mediated demyelinating disorders of the peripheral and central nervous system: acute inflammatory polyneuropathy (Guillain-Barré syndrome), chronic inflammatory demyelinating polyneuropathy, and multiple sclerosis. In a...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-198608000-00018
更新日期:1986-08-01 00:00:00
abstract::A controlled trial of treatment of chronic osteomyelitis caused by Staphylococcus aureus compared nafcillin alone with nafcillin plus rifampin for a six-week period. Treatment was well tolerated, the only adverse effect being mild neutropenia in four of 18 patients; no toxicity was observed from rifampin. Eight of ten...
journal_title:Southern medical journal
pub_type: 临床试验,杂志文章
doi:10.1097/00007611-198608000-00008
更新日期:1986-08-01 00:00:00
abstract::A woman developed anterior uveitis at age 24, inflammatory bowel disease at age 29, and ankylosing spondylitis at age 45 by history. There were frequent recurrences. An HLA-B27 test was positive at age 53. The literature indicates that all of these conditions together in a HLA-B27-positive woman are uncommon. Physicia...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.smj.0000215747.80424.2d
更新日期:2006-05-01 00:00:00
abstract::Intraorbital hydatid disease (IHD) is quite rare and represents < 1% of the Echinococcus cases. In our current communication, we report two children with solitary, primary intraorbital hydatid cysts. Both children presented with nontender, nonpulsatile proptosis. Imaging workup, including CT and MRI scans of the head ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.smj.0000217492.03019.16
更新日期:2006-06-01 00:00:00
abstract::Of ten patients with anterior diaphragmatic hernia treated by operation, only three had shortness of breath and chest pain. The remainder of the patients were referred to us because of a roentgenographic abnormality. All patients have had follow-up of between six months and 11 years without recurrence. Surgical repair...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198203000-00008
更新日期:1982-03-01 00:00:00
abstract::Three members of a family with Peutz-Jeghers syndrome had intussusception due to intestinal hamartomas. In addition, the grandfather had carcinoma of the jejunum, and the granddaughter had benign ovarian sex cord/stromal tumor causing sexual precocity. Benign and malignant tumors, not often associated with Peutz-Jeghe...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199110000-00011
更新日期:1991-10-01 00:00:00
abstract::A case of Wuchereria bancrofti filariasis was recently seen in a Haitian immigrant in Charleston, SC. The Caribbean area is a known endemic focus for this organism. With the increased numbers of immigrants from that area, it is likely that other such cases will be seen in the US. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198504000-00032
更新日期:1985-04-01 00:00:00
abstract:BACKGROUND:Screening mammography, particularly for women in their 40s, has become a confusing issue for many physicians. Recent scientific and political controversies regarding screening guidelines have added to this confusion. METHODS:Many randomized clinical trials have shown the benefits of mammographic screening f...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1998-06-01 00:00:00
abstract::We have described a case of maternal primary aldosteronism in which there is virilization of the female offspring. The most common causes of virilization are considered unlikely on the basis of clinical and laboratory data. The report illustrates the exacerbation of aldosteronism that occurs postpartum and emphasizes ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1983-04-01 00:00:00
abstract::Liver amyloidosis is very rare but is relatively common within the group of amyloid diseases. Jaundice seldom accompanies this condition. Since the results of liver tests are often abnormal, liver amyloidosis cannot be diagnosed by symptoms alone. Diagnosis is provided only by liver or rectal biopsy. We have described...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197907000-00041
更新日期:1979-07-01 00:00:00
abstract::Angioedema has not been associated with losartan therapy in hemodialysis patients, as it has been with angiotensin converting enzyme (ACE) inhibitors. We report the case of a hemodialysis patient who previously had angioedema after therapy with ACE inhibitors and again had angioedema while taking losartan. We suggest ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199705000-00020
更新日期:1997-05-01 00:00:00
abstract::We describe two patients who had tuberculomas that were initially misdiagnosed as neurosarcoidosis, leading to prolonged steroid therapy before initiation of antituberculous medications. Neither patient was infected with the human immunodeficiency virus, and one of the patients had a negative tuberculosis skin test. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000048150.02504.99
更新日期:2003-05-01 00:00:00
abstract::Because of the persistently high mortality from sepsis in cancer patients, a retrospective study was designed to identify the causative organisms and to determine the factors affecting the outcome of sepsis. A total of 84 episodes of septicemia in 61 children with cancer were studied. The more frequently isolated orga...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197902000-00007
更新日期:1979-02-01 00:00:00
abstract::Pregnancy in patients who have non-Hodgkin's lymphoma is unusual. We have reported a case of diffuse, poorly differentiated lymphocytic lymphoma, stage IIIa, in a patient whose disease went into remission after she received six courses of CHOP therapy (cyclophosphamide, doxorubicin, vincristine, and prednisolone). She...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198510000-00032
更新日期:1985-10-01 00:00:00
abstract::A 42-year-old woman had dysentery caused by the Shiga bacillus, Shigella dysenteriae type 1, while taking diphenoxylate with atropine during and after her return from a trip to Mexico. Although she was treated with appropriate antibiotics, she suffered a prolonged and toxic acute course followed by intermittent bouts ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198003000-00034
更新日期:1980-03-01 00:00:00
abstract::This report describes a case of warm-antibody-mediated hemolytic anemia associated with a hypernephroma. Only four patients with renal cell carcinoma and Coombs'-positive hemolytic anemia have been reported previously. Although rare, the occurrence of autoimmune hemolytic anemia in association with a hypernephroma sho...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198509000-00023
更新日期:1985-09-01 00:00:00
abstract::Presented in a case in which calcification of the adrenal gland was roentgenographically evident on the first day of life. The earliest previously reported case of adrenal calcification was at 8 days of age and was attributed to an intrapartum hemorrhage. It is proposed that an intrauterine third trimester insult was ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197903000-00045
更新日期:1979-03-01 00:00:00
abstract::We have described a case in which the diagnosis of multiple sclerosis with findings of progressive paraplegia and a neurogenic bladder led to supravesical urinary diversion. Pyocystis led to creation of a urethrovesicovaginal fistula. Psychotherapy later uncovered hysterical conversion reaction. Which was cured with h...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198109000-00039
更新日期:1981-09-01 00:00:00
abstract::While in most states information physicians obtain from the about patients is confidential and cannot be disclosed without the patient's permission, a recent California Supreme Court decision affirms that when the doctor reasonably believes his patient can cause violent harm to third persons, he had an overriding duty...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197903000-00030
更新日期:1979-03-01 00:00:00
abstract::We have presented three patients in whom a striking desquamating perineal rash developed within the first five days of a febrile illness. Such a rash should raise the suspicion for Kawasaki syndrome even when all criteria are not present. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198807000-00039
更新日期:1988-07-01 00:00:00
abstract:BACKGROUND:This study was designed to identify differences among internists in their attitudes about diabetes and how those attitudes influence practice behavior. METHODS:A cross-sectional study of 55 internists in an academic medical center was done using the Diabetes Attitude Scale (DAS-3), a valid and reliable meas...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2002-01-01 00:00:00
abstract::We have described a case of chronic pancreatitis due to stenosing papillitis relieved by sphincteroplasty and removal of pancreatic duct stones, as opposed to a major pancreatic resection. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198310000-00033
更新日期:1983-10-01 00:00:00
abstract:BACKGROUND:Echocardiographic demonstration of valvular infection now ranks with positive blood cultures as one of the two major clinical criteria for diagnosis of infective endocarditis (IE), according to new, more accurate guidelines for diagnosis. Because early detection of IE and its complications is essential for d...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1999-08-01 00:00:00
abstract::Subdural hematomas are among the most common forms of intracranial hemorrhage encountered in clinical practice and are a surgically remediable cause of dementia. When the symptom presentation is subtle or diffuse, a subdural hematoma can be overlooked. This is especially true among elderly people who may exhibit unrel...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199509000-00019
更新日期:1995-09-01 00:00:00
abstract::For over a decade there has been concern about hepatitis related to halothane anesthesia. No dose relationship or other direct cause has ever been established, and jaundice has been found to occur after other anesthetics for surgical operations. Enflurane is a newer halogenated compound with a remarkable record of saf...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197807000-00012
更新日期:1978-07-01 00:00:00
abstract::This paper explores the possibility that bed sharing may carry particular risks for children with special healthcare needs (CSHCN). Two cases of CSHCN who may have sustained adverse health effects from bed sharing are described. These two case reports indicate that CSHCN may be particularly susceptible to risks associ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.smj.0000220843.75686.cb
更新日期:2006-09-01 00:00:00
abstract::We have described three cases of adenomyoma of the stomach. These benign lesions are found almost exclusively in the antrum or pylorus and are composed of combinations of ducts, glands, pancreatic tissue, and smooth muscle. Malignancy arising in adenomyomas is rare. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198410000-00037
更新日期:1984-10-01 00:00:00
abstract::Children with sickle cell anemia who were less than 5 years old were observed over a three-year period. Those born to recent Haitian immigrants accounted for 108.4 patient-years. They had seven episodes of Streptococcus pneumoniae bacteremia and five due to Haemophilus influenzae for rates of 6.5 and 4.6 episodes per ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198907000-00009
更新日期:1989-07-01 00:00:00
abstract:BACKGROUND:The Orthopaedic In-Training Examination (OITE) provides an objective way for both the residency program and the resident to monitor progress. METHODS:This longitudinal descriptive study tracks the OITE performance of 16 residents from one orthopaedic surgery residency program over nine years (1997-2005). Do...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e31817c0ba6
更新日期:2008-08-01 00:00:00