Abstract:
OBJECTIVE: Severe maternal morbidity (SMM) has increased by 45% in the United States and is estimated to affect up to 1.5% of all deliveries. Research has not yet been conducted that demonstrates a benefit to multidisciplinary review of SMM. The aim of our study was to determine if standardized, routine review of the cases of SMM by a multidisciplinary committee results in a reduction of potentially preventable cases of SMM. STUDY DESIGN: A retrospective cohort study of all women admitted for delivery at Cedars-Sinai Medical Center from March 1, 2012 to September 30, 2016. Our cohort was separated into two groups: a preintervention group composed of women admitted for delivery prior to the implementation of the obstetric Quality and Peer Review Committee (OBQPRC), and a postintervention group where the committee had been well established. Cases of confirmed SMM were presented to a multidisciplinary research committee, and the committee determined whether opportunities for improvement in care existed. The groups were compared with determine if there was a decreased incidence of preventable SMM following the implementation of the OBQPRC standardized review process. RESULTS: There were 30,319 deliveries during the study period; 13,120 deliveries in the preintervention group; and 13,350 deliveries in the postintervention group (2,649 deliveries during the transition period). There was no difference in the rate of SMM between the preintervention (125; 0.95%) and postintervention (129; 0.97%) groups, (p = 0.91). There was a significantly lower rate of opportunity for the improvement in care in the postintervention group (29.5%) compared with the preintervention group (46%; p = 0.005). CONCLUSION: We demonstrated a significant reduction in the rate of potentially preventable SMM following the implementation of routine review of all SMM suggesting that this process plays an important role in improving maternal care and outcomes. KEY POINTS:· Benefit to routine review of SMM has not been demonstrated.. · Routine review of SMM is associated with 36% reduction in potentially preventable SMM.. · This is the first study to demonstrate the benefit of routine review of SMM..
journal_name
Am J Perinatoljournal_title
American journal of perinatologyauthors
Ozimek JA,Greene N,Geller A,Zakowski M,Wong MS,Franco R,Kilpatrick SJdoi
10.1055/s-0040-1715846subject
Has Abstractpub_date
2020-08-30 00:00:00eissn
0735-1631issn
1098-8785pub_type
杂志文章abstract::The significance and management of prepartum bradycardia is not well established in prepartum fetal assessment. The incidence of prolonged bradycardia was 3.5% (45 per 1284), defined as a decrease of greater than or equal to 40 beats per minute of the fetal heart rate (FHR) below the baseline for at least 2 minutes. T...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999972
更新日期:1985-10-01 00:00:00
abstract::Objective We aimed to evaluate which patient-level factors influence mode of delivery among candidates for operative vaginal delivery. Study Design Cross-sectional study of candidates for operative vaginal delivery from 18 hospitals over 8 years. Probabilities of mode of delivery were estimated using hierarchical logi...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0037-1601441
更新日期:2017-08-01 00:00:00
abstract::We compared perinatal outcomes between live-born nonisolated and isolated omphaloceles diagnosed during a prenatal ultrasound. Fetuses (n = 86) with omphalocele were identified between 1995 and 2007 at a single institution. Inclusion criteria were an omphalocele >14 weeks' gestation, available fetal and/or neonatal ka...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0031-1276737
更新日期:2011-09-01 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::Background It is unclear how adherence to the Institute of Medicine's (IOM) guidelines for weight gain affects pregnancy outcomes. Objective We investigated how weight gain outside the IOM's recommendations affects the risks of adverse pregnancy outcomes. Study Design We performed a secondary analysis of a prospective...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0036-1584583
更新日期:2017-01-01 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::Gestational diabetes mellitus (GDM) has increased dramatically in the past 20 years together with the obesity epidemic. Mirroring the increase in incidence of GDM is increasing use of endocrine disrupting chemicals (EDCs). EDCs are structurally similar to endogenous hormones and interfere with synthesis, secretion, ac...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-0036-1586500
更新日期:2016-11-01 00:00:00
abstract::Interest in centralized monitoring in labor and delivery units is growing because it affords the opportunity to monitor multiple patients simultaneously. However, a long history of research on sustained attention reveals these types of monitoring tasks can be problematic. The goal of the present experiment was to exam...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0030-1268718
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVE:This study aimed to evaluate temporal trends in opioid use disorder (OUD) during antepartum and postpartum hospitalizations. STUDY DESIGN:This repeated cross-sectional analysis analyzed data from the National (Nationwide) Inpatient Sample. Women aged 15 to 54 years admitted antepartum or postpartum were iden...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0039-1694725
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:We sought to examine pathogen distribution and clinical presentation of late-onset sepsis (LOS) at an urban tertiary care center. STUDY DESIGN:We performed a retrospective review of all culture-confirmed cases of LOS presenting to our institution from 2013 to 2017. Medical records were evaluated for demograp...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1675643
更新日期:2019-09-01 00:00:00
abstract::In this paper the results gathered in a longitudinal ultrasound study (LS) of fetal growth are presented. The study is unusual in design because of its homogeneity, the number of parameters recorded, the exact spacing between the examinations, and the number of examinations per subject. Information not available in th...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999987
更新日期:1984-01-01 00:00:00
abstract::A recent report has noted an association between Helicobacter pylori and hyperemesis gravidarum. We present two cases in which first-trimester patients with severe hyperemesis gravidarum requiring intravenous fluid replacement were placed on oral erythromycin therapy for other nonrelated conditions. Surprisingly, mark...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994055
更新日期:1998-01-01 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::Periventricular leukomalacia, a condition characterized by hpoxic-ischemic infarction of deep cerebral white matter, can now be recognized by cranial sonography. The case presented here demonstrates the association of periventricular leukomalacia present at birth with intrauterine paroxysmal supraventricular tachycard...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999826
更新日期:1986-01-01 00:00:00
abstract::There were 107 episodes of pyelonephritis associated with pregnancy or the early puerperium occurring in 103 gravidas investigated retrospectively for information concerning prematurity, low birthweight, and antibiotic susceptibility patterns in the recovered microorganisms. No difference was found in the incidence of...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999800
更新日期:1987-10-01 00:00:00
abstract::We studied the relationships between fetal hemoglobin concentration, acid base status, and lactate concentration in umbilical venous and fetal heart blood in 157 fetuses affected by blood group incompatibility who had been exposed for 214 fetal blood sampling procedures (cordocentesis in 153 and intracardiac puncture ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994524
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:The definition of postpartum hemorrhage (PPH) was developed more than 50 years ago. Since then, the obstetric population has changed dramatically. We sought to determine how well we estimated blood loss (EBL) and find thresholds predicting need for transfusion. STUDY DESIGN:We performed a prospective cohort ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0035-1552940
更新日期:2015-11-01 00:00:00
abstract::Pleural effusion is not an uncommon complication of percutaneous intravenous catheters in neonates. Umbilical venous catheters (UVCs) are associated with pleural effusion following abnormal placement in the left atrium or pulmonary veins due to venous obstruction. We report for the first time a case of right-sided ple...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-992174
更新日期:2007-11-01 00:00:00
abstract:: ...
journal_title:American journal of perinatology
pub_type: 杂志文章,已发布勘误
doi:10.1055/s-0038-1660792
更新日期:2018-07-01 00:00:00
abstract::Infection-related neonatal mortality due to omphalitis in developing country home births is an important public health problem. Three cluster randomized trials of 4% chlorhexidine applied to the umbilical cord stump from once to multiple times in the days following a home birth have evaluated this intervention compare...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1329695
更新日期:2013-09-01 00:00:00
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 freque...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-993900
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:Systemic lupus erythematosus (SLE) increases the risk of complications in pregnancy. Hydroxychloroquine (HCQ) decreases flares and neonatal lupus syndrome. Limited evidence suggests that HCQ also reduces preeclampsia and preterm birth in SLE pregnancies. We studied whether HCQ was associated with lower odds o...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0039-3402752
更新日期:2020-07-01 00:00:00
abstract::The objective of this article is to evaluate the plasma levels of coagulation and fibrinolysis parameters in the third trimester of gestation and 72 hr postdelivery. Antithrombin III (ATIII), thrombin-antithrombin III complexes (TAT), heparin cofactor II (HCII), protein C (PC), protein S (PS), tissue plasminogen activ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-993903
更新日期:1998-02-01 00:00:00
abstract:OBJECTIVE:Surfactant and noninvasive ventilation are two major strategies for the treatment of neonates with respiratory distress syndrome (RDS). However, the optimal time for surfactant administering is yet controversial. This study compared the early and rescue Calsurf administration in preterm infants with RDS. STU...
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-0039-1678530
更新日期:2019-12-01 00:00:00
abstract::The most frequently used set of gestational age-birth weight curves in the United States is the Colorado (C) standard published in 1963. To investigate the usefulness of this standard in an urban population at sea level, we examined the birth weight vs gestational age data from 56,675 singleton liveborn infants born b...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999785
更新日期:1987-07-01 00:00:00
abstract::We sought to describe a case series and literature review of uterine rupture in the absence of a previous cesarean delivery. In addition to four cases in our institution, a search of the literature from 1994 to 2008 identified cases of uterine rupture unrelated to a prior cesarean. Uterine rupture in the absence of a ...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-0029-1223287
更新日期:2009-11-01 00:00:00
abstract::The novel coronavirus disease 2019 (COVID-19) pandemic has resulted in changes to perinatal and neonatal care, concentrating on minimizing risks of transmission to the newborn and health care staff while ensuring medical care is not compromised for both mother and infant. Current recommendations on infant care and fee...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1716506
更新日期:2020-11-01 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::Seventy premature infants (birthweight 1.75 kg or less, gestational age 33 weeks or less) with hemoglobin less than 10 g/dL and hematocrit less than 30% were studied and randomly divided into three groups. All of them received oral elemental iron 3 mg/kg/day and vitamin E 5 mg/kg/day during the study period. Recombina...
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-2007-994483
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Congenital pulmonary airway malformation (CPAM) is a group of rare congenital malformations of the lung and airways. Lung ultrasound (LU) is increasingly used to diagnose neonatal respiratory diseases since it is quick, easy to learn, and radiation-free, but no formal data exist for congenital ...
journal_title:American journal of perinatology
pub_type: 杂志文章,多中心研究
doi:10.1055/s-0038-1645861
更新日期:2018-10-01 00:00:00