Abstract:
OBJECTIVE: The purpose of this study was to compare the nulliparous-term-singleton-vertex (NTSV) and the Society of Maternal-Fetal Medicine (SMFM) cesarean birth metrics as tools for quality improvement efforts based on hospital size. MATERIALS AND METHODS: Cesarean birth rates from 275 hospitals from six states were used to evaluate the NTSV metric and 81 hospitals from four states for the SMFM metric. Data were assessed based on delivery volume, their use as an effective tool for ongoing quality improvement programs, and their ability to serve as performance-based payline indicators. RESULTS: The average NTSV and SMFM cesarean birth rates were 25.6 and 13.0%, respectively. The number of deliveries included in the NTSV metric was stable across all hospital sizes (33.1-36.2%). With the SMFM metric, there was a progressive decline in the number of deliveries included, 90.0 versus 69.6%, in relatively small to large facilities. Variability was less and precision increased with the SMFM metric, which reduced the number of hospitals that could be incorrectly categorized when using performance-based predefined cesarean birth rate paylines. CONCLUSION: The SMFM metric appears to be better suited as a tool for rapid process improvement programs aimed at reducing cesarean birth rates in low-risk patients.
journal_name
Am J Perinatoljournal_title
American journal of perinatologyauthors
Shields LE,Walker S,Hedriana HL,Wiesner S,Pelletreau B,Hitti J,Benedetti TJdoi
10.1055/s-0037-1607985subject
Has Abstractpub_date
2018-03-01 00:00:00pages
390-396issue
4eissn
0735-1631issn
1098-8785journal_volume
35pub_type
杂志文章,多中心研究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::Acute physiologic changes induced by the infusion of resuscitative fluids may be harmful, resulting in the clinical sequelae of pulmonary and intraventricular hemorrhage. Using a chronically catheterized lamb model, changes in plasma sodium concentration, osmolality, hematocrit, glucose, colloid osmotic pressure, and ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-1000056
更新日期:1983-10-01 00:00:00
abstract::There is increasing concern about Chlamydia trachomatis infection during pregnancy, because of reports of increased maternal, fetal, and neonatal risks. Amniotic fluid is known to possess antibacterial activity and has recently been shown to inhibit formation of chlamydial inclusions in McCoy cell culture. To further ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999341
更新日期:1991-01-01 00:00:00
abstract::The antioxidant enzyme paraoxonase 1 is a marker of oxidative stress and has been implicated in the pathogenesis of preeclampsia. Our objective was to determine if an association exists between low paraoxonase 1 activity at midgestation and the development of preeclampsia. We conducted a case-control study of 50 women...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0029-1236438
更新日期:2010-03-01 00:00:00
abstract::We compared short-term neonatal outcomes between premature infants with spontaneous preterm birth (s-PTB) and those delivered due to preeclampsia (PEC). Data were collected from women with singleton pregnancies admitted with spontaneous preterm labor (PTL) (2002 to 2005) and PEC (2005 to 2007). Patients delivering 24 ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0029-1234036
更新日期:2010-02-01 00:00:00
abstract::The manifestations of fetal varicella syndrome usually involve several organ systems, including skin, ocular, neurologic, gastrointestinal, and genitourinary. Although ocular anomalies have been reported to be as high as 68%, manifestations limited to the eyes is extremely rare. Herein we report the case of fetal vari...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994493
更新日期:1995-09-01 00:00:00
abstract:AIM:The main purpose of this article is to assess trends in cytomegalovirus (CMV) infection reported among infants in California neonatal intensive care units (NICUs) during 2005 to 2016. STUDY DESIGN:The California Perinatal Quality Care Collaborative collects data on all very low birth weight (VLBW, birth weight ≤ 1...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0039-1683958
更新日期:2020-01-01 00:00:00
abstract::The findings of hyperechoic and enlarged fetal kidneys on routine antenatal ultrasonography is a non-specific finding that alerts the physician to a differential diagnosis of various genetic and non-genetic disorders, including fetal polycystic disease and Beckwith-Wiedeman syndrome. Detection of fetal or neonatal pol...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994309
更新日期:1996-04-01 00:00:00
abstract::A fiber-enriched diabetic diet that contained a modest increase in dietary fiber and a commercially available fiber supplement was studied in pregnant diabetic women for its potential glucose-lowering effects. Noninsulin-requiring gestational diabetic patients were placed on a fiber-enriched diet of increasing fiber c...
journal_title:American journal of perinatology
pub_type: 临床试验,杂志文章
doi:10.1055/s-2007-994738
更新日期:1993-07-01 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::This communication examines the diagnostic value of the leukocyte esterase activity (LEA) test in the detection of intra-amniotic infection. Amniotic fluid from 171 consecutive patients with premature rupture of membranes (n = 149) and preterm labor (n = 22) was obtained through amniocentesis. Gram stain, bacterial an...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999657
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:Prediction of gestational latency after placement of physical exam indicated cerclage (PEIC) is limited. Uterocervical angle (UCA) has been associated with spontaneous preterm delivery in the general population. Our objective was to examine whether UCA is associated with gestational latency in women with PEIC...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0037-1621734
更新日期:2018-07-01 00:00:00
abstract::The objective of this study was to identify the most efficient and cost-effective nebulizer device for delivery of albuterol aerosol as a bronchodilator in ventilated preterm infants. Bronchodilators are frequently used as part of the therapeutic regimen of ventilated preterm infants. This can be delivered by differen...
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-2001-14526
更新日期:2001-05-01 00:00:00
abstract:OBJECTIVE:This study aims to develop a scoring system for the prediction of bronchopulmonary dysplasia (BPD). METHODS:Medical records of 652 infants whose gestational age and birth weight were below 32 weeks and 1,500 g, respectively, and who survived beyond 28th postnatal day were reviewed retrospectively. Logistic r...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0034-1393935
更新日期:2015-06-01 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::This study was undertaken to determine the plasma and erythrocyte profiles of metabolically important nonesterified polyunsaturated fatty acids (PUFA), that is, free fatty acids, in each trimester of pregnancy and in labor. Blood was drawn from patients in the first, second, and third trimester and in labor. Nonesteri...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2008-1040766
更新日期:1997-11-01 00:00:00
abstract::Premature closure of the foramen ovale is a rare cardiac anomaly. Severe right-sided heart failure accounts for the hepatomegaly, ascites, pleural and pericardial effusions, and generalized edema of these hydropic fetuses. Premature closure of the foramen ovale should be a part of the differential diagnosis when unexp...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994616
更新日期:1994-11-01 00:00:00
abstract:OBJECTIVE:The objective of this article is to evaluate the implementation and acceptability of a universal cervical length (CL) screening program for prediction and prevention of preterm birth (PTB). STUDY DESIGN:We performed a prospective observational study to evaluate the implementation and acceptability of a unive...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0034-1371710
更新日期:2014-12-01 00:00:00
abstract::The purpose of this study was to examine the maternal risk factors associated with early onset Group B streptococcus (GBS) sepsis and determine the potential impact of intrapartum chemoprophylaxis using these risk factors. Using a computerized perinatal database, 26,525 deliveries over a five-year period (1989 to 1994...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994433
更新日期:1996-11-01 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
abstract::We describe the neuropathologic procedure utilized in the Stillbirth Collaborative Research Network (SCRN), focusing on the examination of central nervous system (CNS) in stillbirth (SB). The SCRN was organized to perform a case-control study to determine the scope and causes of SB. Pathologists at all the participati...
journal_title:American journal of perinatology
pub_type: 杂志文章,多中心研究
doi:10.1055/s-0031-1284229
更新日期:2011-12-01 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 effect of increasing maternal obesity, including superobesity (body mass index [BMI] ≥ 50 kg/m2), on perinatal outcomes in women with diabetes. STUDY DESIGN:Retrospective cohort study of birth records for all live-born nonanomalous singleton infants ≥ 37 weeks' gestation born to Missouri res...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0033-1347363
更新日期:2014-03-01 00:00:00
abstract::Endotracheal instillation and subsequent suctioning produces fluctuations of intracranial pressure (ICP), mean arterial pressure (MAP), and cerebral perfusion pressure (CPP) in sick preterm infants. In an attempt to observe if these fluctuations could be minimized using sedation, we studied a group of seven sick mecha...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999841
更新日期:1986-04-01 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:OBJECTIVE:To determine the associations of measured protein, energy, and protein-to-energy (PER) intakes with body composition in human milk (HM)-fed preterm infants. STUDY DESIGN:Neonates born at < 33 gestational weeks were eligible. Standard fortification method with modular supplements was used and the HM compositi...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1626717
更新日期:2018-07-01 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:OBJECTIVE:This study aimed to examine whether labor before cesarean affects the risk of placenta accreta spectrum (PAS) disorders in a subsequent pregnancy. STUDY DESIGN:This is a secondary analysis of the Cesarean Registry, a prospective cohort study of women undergoing cesarean between 1999 and 2002. Women with one ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0039-1685449
更新日期:2020-05-01 00:00:00
abstract:INTRODUCTION:Many tertiary neonatal units employ a restricted visiting policy. Webcams have previously been implemented in the neonatal unit setting in several countries. OBJECTIVES:This study aims to determine the views from parents, physicians, and nursing staff before implementation of a webcam system. METHODS:A q...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0034-1376388
更新日期:2015-02-01 00:00:00
abstract::The use of transabdominal vibroacoustic stimulation has been shown to improve the efficiency of antepartum fetal surveillance. The ability of the fetus to habituate to such a stimulus has also been suggested as a means of assessing the function of the central nervous system. The purpose of this blinded prospective inv...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999420
更新日期:1991-11-01 00:00:00