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 the multimodal protocol or matching placebos. The multimodal protocol consisted of a preoperative dose of intravenous acetaminophen, preincision injection of subcutaneous bupivacaine, and intraoperative injection of intramuscular ketorolac. Primary outcome was total opioid intake at 48 hours postoperatively. Secondary outcomes were pain scores, time to first opioid intake, neonatal outcomes, and total outpatient opioid intake on postoperative day (POD) 7. Data were analyzed using parametric and nonparametric tests and quantile regression as appropriate. RESULTS:A total of 242 women were screened with 120 randomized, 60 to the multimodal group and 60 to control group. There was no significant difference in the primary outcome of opioid use nor in the secondary outcomes. Smokers and patients with a history of drug use had higher median postoperative opiate use and earlier administration. On POD 7, only 40% of prescribed opioids had been used, and there was no difference between the groups. CONCLUSION:This perioperative multimodal pain regimen did not reduce opioid use in 48 hours after CD. Patients who smoke or with a history of drug use required more opioids in the postoperative period. Providers significantly overprescribed opioids after CD.
journal_name
Am J Perinatoljournal_title
American journal of perinatologyauthors
Hadley EE,Monsivais L,Pacheco L,Babazade R,Chiossi G,Ramirez Y,Ellis V,Simon M,Saade GR,Costantine Mdoi
10.1055/s-0039-1681096subject
Has Abstractpub_date
2019-09-01 00:00:00pages
1097-1105issue
11eissn
0735-1631issn
1098-8785journal_volume
36pub_type
杂志文章,随机对照试验abstract::The objective of this study was to perform antiphospholipid antibody screening in women with chronic hypertension to assess whether the presence of such antibodies is associated with adverse pregnancy outcome. Serum for anticardiolipin antibodies and lupus anticoagulant was obtained in pregnant women with chronic hype...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2004-829870
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVE: Sepsis is a major cause of neonatal mortality. The gold standard for diagnosis is blood culture which suffers from low sensitivity and huge turn-around time. Flow cytometry has been extensively applied to malignant disorders and is an upcoming tool for diagnosis of nonmalignant disorders due to its rapidity ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1718370
更新日期:2020-09-29 00:00:00
abstract::Two cases of fetal myocardial calcification confirmed postnatally are reported. In contrast to other reports, both infants survived with resolution of calcification by 6 and 12 months. Diagnostic investigations failed to confirm the presence of congenital infection. Both pregnancies were complicated by early cocaine u...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2008-1040740
更新日期:1994-05-01 00:00:00
abstract::Care of women with preterm labor has been reported by Katz et al to be enhanced by use of an electronic uterine contraction monitor. We enrolled 76 women with singleton gestations who had been successfully treated for preterm labor into a prospective randomized trial, assigning subjects in a ratio of 1:2 to a group of...
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-2007-999473
更新日期:1990-04-01 00:00:00
abstract::Limited research in young adults and immature animals suggests a detrimental effect of tobacco on bone during growth. We aimed to determine the adverse effects of maternal nicotine exposure during pregnancy and lactation on neonatal rat bone development, and to determine a protective effect of ascorbic acid. Gravid ra...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2006-951287
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy of similar buccal and vaginal misoprostol doses for induction of labor. STUDY DESIGN:Retrospective chart review of 207 consecutive women undergoing term induction of labor with misoprostol. Misoprostol route and dosing were collected. Time to delivery and other labor outcomes (e.g., v...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1675219
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE: According to the most recent metanalysis, the best way to establish safe enteral feeding in preterm babies using nasogastric or orogastric tubes is still not well understood. This study aimed to determine the effects of bolus nasal tubes versus bolus orogastric tubes on the time required to reach full entera...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1713865
更新日期:2020-07-03 00:00:00
abstract:OBJECTIVE:To assess the association between altitudes of neonatal intensive care units (NICU) and the rate of bronchopulmonary dysplasia (BPD) and BPD/death in very preterm infants. STUDY DESIGN:Data from infants born at <33 weeks' gestation admitted to Canadian Neonatal Network during 2008 and 2009 were analyzed. The...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0032-1329690
更新日期:2013-08-01 00:00:00
abstract::Exposure to immunosuppressant agents during gestation can affect the fetal immune system. The aim of this study was to evaluate the immune function of infants whose mothers were administered immunosuppressants during pregnancy for the treatment of autoimmune disorders. Circulating lymphocyte subsets and in vitro immun...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-986679
更新日期:2007-09-01 00:00:00
abstract::The objective of this paper is to examine whether growth-restricted preterm infants have a different neonatal outcome than appropriately grown preterm infants. All consecutive, singleton preterm deliveries between 27-35 weeks' gestation were included over a 4-year period. Infants with congenital anomalies and infants ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2000-9423
更新日期:2000-01-01 00:00:00
abstract::Nine patients with posthemipelvectomy with subsequent delivery of 13 living children are reported in the world's literature. This radical procedure is possible only in a modern age of intensive medical and surgical support. Additional cases can be expected in the future. We present two additional patients and three ch...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-2007-999616
更新日期:1989-07-01 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::We sought to identify prenatal predictive factors for perinatal outcome and to estimate fetal hemoglobin (Hb) levels in large fetomaternal hemorrhages (transfused blood volume [TBV] > 20 mL) by performing a case-series study ( N = 32). Perinatal outcome was favorable (F group, N = 22) and poor (P group, N = 10: four f...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0028-1103150
更新日期:2009-03-01 00:00:00
abstract::The ultrastructural architecture of colostral cells of mothers of pre- and full-term infants is described. The polymorphonuclears were engaged in vivid phagocytosis of fat droplets. Similar findings were observed on the macrophages. The lymphocytes appeared normal in size and ultrastructure. A small number of eosinoph...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994162
更新日期:1997-07-01 00:00:00
abstract:OBJECTIVE: This work aimed to study perinatal, maternal, and neonatal characteristics of birth tourism (BT) mother-baby dyads and the rate of neonatal intensive care unit (NICU) admissions of BT infants. STUDY DESIGN: Retrospective study at a regional perinatal center comparing BT mother-baby dyads to all dyads. BT in...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1719117
更新日期:2020-11-09 00:00:00
abstract::Intra-amniotic infection is often the cause of a second-trimester abortion. The bacterial species involved include bacteria with low pathogenicity like Ureaplasma urealyticum and various Mycoplasma species. In this case we describe an intra-amniotic infection caused by Capnocytophaga sputigena, often found in the norm...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-993854
更新日期:1999-01-01 00:00:00
abstract::We present an unusual case of a primigravida with a viable cervical pregnancy diagnosed by transvaginal ultrasound and magnetic resonance imaging. Staggered conservative therapeutic measures included systemic high-dose Methotrexate with Folinic acid rescue followed by bilateral embolization of the uterine arteries in ...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-2003-42341
更新日期:2003-07-01 00:00:00
abstract:OBJECTIVE: Potentially avoidable maternity complications (PAMCs) have been validated as an indicator of access to quality prenatal care. African-American mothers have exhibited a higher incidence of PAMCs, which has been attributed to unequal health coverage. The objective of this study was to assess if racial disparit...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1701195
更新日期:2020-01-27 00:00:00
abstract::The aim of this study was to determine the risk of respiratory distress syndrome (RDS) and neonatal death (NND) in relation to birth weight in preterm neonates. A group of 255 singleton preterm neonates born at 22-36 weeks were examined. The mean birth weight for each gestational week was estimated from a fitted curve...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994327
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVE:This article compares hemodynamic characteristics of neonates with hypoxic ischemic encephalopathy (HIE) receiving therapeutic hypothermia (TH) with normal versus abnormal brain magnetic resonance imaging (MRI). METHODS:Serial echocardiography (echo) was performed within 24 hours, after 48 to 72 hours of coo...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1629900
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:To develop a model to predict cesarean-associated red blood cell transfusion. STUDY DESIGN:Secondary analysis of all cesarean deliveries in the Maternal-Fetal Medicine Units Network Cesarean Registry. Using a split-sample technique, the derivation group was used to identify associated factors and build predi...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0039-1678604
更新日期:2019-07-01 00:00:00
abstract::This study was performed at University Medical Center, Lubbock, Texas, from July 1989 to June 1990. We obtained serum gentamicin peak and trough levels in 23 pregnant women with pyelonephritis. The patients were given a loading dose of 2 mg/kg gentamicin, followed by 1.5 mg/kg gentamicin adjusted for obesity every 8 h...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994533
更新日期:1994-01-01 00:00:00
abstract::We present transvaginal ultrasonographic findings of a fetus with Dandy-Walker malformation and associated massive obstructive hydrocephalus at 13 weeks' gestation. First-trimester ultrasonographic diagnosis of Dandy-Walker malformation is uncommon with only two such occurrences having been reported previously. These ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2001-18697
更新日期:2001-11-01 00:00:00
abstract::Chart review of 73 patients with 3.5 cm or more dilation, intact membranes, and regular contractions at less than 36 weeks. Forty-four (group A) received tocolysis with magnesium sulfate, and 13 of the 44 also received indomethacin. Twenty-nine (group B) received no tocolysis. Obstetric and neonatal outcomes were comp...
journal_title:American journal of perinatology
pub_type: 临床试验,杂志文章
doi:10.1055/s-2007-994478
更新日期:1995-07-01 00:00:00
abstract:OBJECTIVE: To determine the association between total gestational weight gain and perinatal outcomes. STUDY DESIGN: Data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be (NuMoM2b) study were used. Total gestational weight gain was categorized as inadequate, adequate, or excessive based on the 20...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0039-1696640
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study is to assess if women with arrested preterm labor (PTL) have an increased risk of preterm delivery (PTD) compared with healthy pregnant women, and if digital examination, fetal fibronectin (fFn) and cervical length (CL) are prognostic markers for PTD after arrested PTL. STUDY DESIGN:Pro...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0034-1374818
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVE: To determine reference values for myocardial volume of the fetal heart using three-dimensional ultrasound with spatiotemporal image correlation (STIC) and virtual organ computer-aided analysis (VOCAL) and to assess their applicability in women with pregestational diabetes. STUDY DESIGN: This retrospective c...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0039-3400983
更新日期:2019-12-13 00:00:00
abstract::Using first trimester fetal crown-rump length (CRL) measurements as the criterion for gestational dating, rather than menstrual history or neonatal gestational age evaluation after birth, may be a more accurate way of evaluating the accuracy of second or third trimester ultrasonic measurements for gestational age esti...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994606
更新日期:1994-11-01 00:00:00
abstract:OBJECTIVE:Postpartum higher-dose oxytocin (80 U) compared with lower dose (10 U) given in 500 mL over 1 hour does not decrease postpartum hemorrhage (PPH) requiring treatment, but reduces the risk of hematocrit decline ≥ 6% among women delivering vaginally. Our objective was to evaluate whether the duration of administ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0034-1370347
更新日期:2014-11-01 00:00:00
abstract::Obstetrical antiphospholipid syndrome (APS) is associated with maternal and fetal morbidity and mortality. Standard treatment with low-dose acetylsalicylic acid and unfractionated heparin has achieved up to a 70 to 80% likelihood of success. Conversely, up to 30% of women with APS will have further pregnancy losses, d...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-2006-931805
更新日期:2006-02-01 00:00:00