Abstract:
:Objective To compare maternal birth complications early versus late in the academic year and to evaluate the impact of resident work hour limitation on the "July effect." Study Design We conducted a retrospective, population-based cohort study of 628,414 singleton births in Washington State from 1987 to 2012 measuring the adjusted risk of maternal peripartum complications early (July/August) versus late (April/May) in the academic year. To control for seasonal outcome variation unrelated to trainees' involvement in care as well as long-term trends in maternal complications unrelated to variation in trainees' effect on outcomes across the academic year, we employed difference-in-differences methods contrasting outcomes at teaching to nonteaching hospitals for deliveries before and after restriction of resident work hours in July 2003. Results Prior to resident work hour limitation in July 2003, women delivering early in the academic year at teaching hospitals suffered more complications (relative risk [RR] 1.05; 95% confidence interval [CI]: 1.00-1.09; p = 0.03). After July 2003, complication risk did not vary significantly across the academic year except at teaching-intensive hospitals, where July/August deliveries experienced fewer complications (RR: 0.95; 95% CI: 0.92-0.98; p = 0.001). Conclusion Women delivering at teaching hospitals early in the academic year suffered a modest but significant increase in complications before but not after resident work hour reform.
journal_name
Am J Perinatoljournal_title
American journal of perinatologyauthors
Peltan ID,Brown CE,Burke AK,Chow EJ,Rowhani-Rahbar A,Crull MRdoi
10.1055/s-0037-1598244subject
Has Abstractpub_date
2017-07-01 00:00:00pages
818-825issue
8eissn
0735-1631issn
1098-8785journal_volume
34pub_type
杂志文章abstract::We evaluated the efficacy, safety, and biological mechanisms of digoxin immune Fab (DIF) treatment of severe preeclampsia. Fifty-one severe preeclamptic patients were randomized in double-blind fashion to DIF ( N = 24) or placebo ( N = 27) for 48 hours. Primary outcomes were change in creatinine clearance (CrCl) at 24...
journal_title:American journal of perinatology
pub_type: 杂志文章,随机对照试验
doi:10.1055/s-0030-1249762
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:To evaluate to what extent indicators of placenta insufficiency are associated with low concentrations of insulin-like growth factor 1 (IGF-1) and IGF-1-binding protein-1 (IGFBP-1) in neonatal blood, and to what extent the concentrations of these growth factors are associated with concentrations of proteins w...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1677472
更新日期:2019-12-01 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::Diagnosis of fetal pulmonary hypoplasia could be of great benefit to the obstetrician in the management of those pregnancies complicated by prolonged preterm ruptured membranes. Ultrasonography and magnetic resonance imaging were employed for fetal diagnosis of pulmonary hypoplasia and we were unable to predict accura...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994689
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVE:This study aims to evaluate vaginal microbiota differences by bacterial vaginosis (BV), birth timing, and race, and to estimate parameters to power future vaginal microbiome studies. METHODS:Previously, vaginal swabs were collected at 21 to 25 weeks (stored at -80°C), and vaginal smears evaluated for BV (Nug...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0035-1565919
更新日期:2016-03-01 00:00:00
abstract::The accuracy of eight ultrasonic fetal weight formulas were analyzed in 1099 fetuses who underwent real-time ultrasound examination within 72 hours prior to delivery. Shepard's formula was most consistently found to give the lowest systematic and random errors throughout all weight categories, though Deter's formula h...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999944
更新日期:1985-07-01 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::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::A randomized clinical trial (RCT) noted that sonographic examination in the third trimester, in conjunction with delivery at term for abnormalities of fetal growth, significantly decreased the likelihood of small-for-gestational-age (SGA) neonates in uncomplicated pregnancies. We identified 15 characteristics of scree...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0032-1321497
更新日期:2013-01-01 00:00:00
abstract::This study was conducted to examine the potential effects of expanded Medicaid coverage for low income women. Statewide birth data for 1983 to 1985 were examined to determine the relationship between prenatal care and admissions to neonatal intensive care units (NICUs) and the costs of this care. An NICU sample was co...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994790
更新日期:1992-07-01 00:00:00
abstract::Aim To determine the challenges, if any, in translating the benefits of surfactant replacement therapy (SRT) to a resource-limited setting. Method This was a retrospective descriptive study comparing the outcome of 75 cases who received surfactant and 69 controls who did not at the University Hospital of the West Indi...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0036-1598023
更新日期:2017-07-01 00:00:00
abstract::A patient with a homozygous marital partner had three progressively less seriously involved RH-positive babies after a fetal demise due to erythroblastosis. Only the first of the three required fetal transfusions. All were Rh genotypically identical. The case is presented for interest and to illustrate an exception to...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999655
更新日期:1988-01-01 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::This is the first reported case in which a Logothetopulos pack was utilized to achieve pelvic hemostasis in a patient requiring a cesarean hysterectomy for placenta accreta with postpartum hemorrhage. The Logothetopulos pack is an easily constructed gauze tamponade method that proved to be life-saving in this case. ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999514
更新日期:1990-10-01 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
abstract::We have examined the trend in the incidence and mortality of intraventricular hemorrhage (IVH) in low birthweight infants from 1981 through 1984. During this time we admitted 407 infants in the first week of life with a birthweight less than or equal to 1500 gm in whom a cranial ultrasonogram or autopsy had been perfo...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999896
更新日期:1986-10-01 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::A patient with congenital antithrombin III deficiency and a history of thromboembolic events prior to pregnancy was successfully treated with subcutaneous heparin alone throughout two pregnancies. Although adjuvant antithrombin III infusions may have a role in the treatment of this disorder, especially in the peripart...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994748
更新日期:1993-07-01 00:00:00
abstract::Anti-Cw is an uncommon cause of clinically significant hemolytic disease of the newborn (HDN). We report an unusually severe case of HDN due to anti-Cw that required phototherapy and exchange transfusion. We also describe a novel PCR-RFLP method for Cw typing of fetal genomic DNA that was used for prenatal diagnosis i...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-993872
更新日期:1999-01-01 00:00:00
abstract::Objectives This study aims to examine the relationship between hospital birth volume and multiple maternal morbidities among low-risk pregnancies in rural hospitals, urban non-teaching hospitals, and urban teaching hospitals, using a representative sample of U.S. hospitals. Study Design Using the 2011 Nationwide Inpat...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0035-1570380
更新日期:2016-05-01 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::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::We report a case of severe, peripheral, and diffuse tissue ischemia after umbilical vein catheterization (UVC) in a preterm newborn born to a preeclamptic mother. Nitroglycerin ointment was used to treat lesions. The recovery was good but partial loss of the distal phalange of one finger and one toe occurred. This is ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2006-946721
更新日期:2006-08-01 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::The objective of this study was to determine if the rate of preeclampsia is increased in triplet as compared to twin gestations. Fifty-three triplet pregnancies between 1986 and 1993 at The New York Hospital-Cornell Medical Center were reviewed. These were matched for maternal age, parity, and race to twin gestations ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994140
更新日期:1997-05-01 00:00:00
abstract:OBJECTIVES:To describe the trend and factors associated with the autopsy over the past decade at a level III neonatal intensive care unit (NICU) where all patients are presented with an option. STUDY DESIGN:Retrospective study of the autopsy in a cohort of infants who died in the NICU from January 1, 2001, to December...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0032-1332798
更新日期:2013-10-01 00:00:00
abstract::The relationship between low ponderal index and cerebral palsy was evaluated. National Collaborative Perinatal Project and University of California Child Health and Development Study data were analyzed. Associations between low ponderal index (ponderal index < 5% for gestational age) were evaluated in the combined pop...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994129
更新日期:1997-04-01 00:00:00
abstract::Neonatal intussusception in premature infants is uncommon and may mimic other abdominal disorders. We present a case of intussusception in a very low birthweight neonate. Presenting signs initially suggested necrotizing enterocolitis and meconium disease, and the diagnosis was confirmed at laparotomy. ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999916
更新日期:1985-04-01 00:00:00
abstract:OBJECTIVE: This study aimed to the assess risk of respiratory morbidity in neonates born to women with gestational diabetes mellitus (GDM) delivered after labor compared with those delivered without exposure to labor. STUDY DESIGN: This is a secondary analysis of a prospective single-center cohort study of singleton p...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1716483
更新日期:2020-09-06 00:00:00
abstract::Hermansky-Pudlak syndrome (HPS) is a multisystem, autosomal-recessive disorder characterized by oculocutaneous albinism, platelet storage pool deficiency resulting in prolonged bleeding, and ceroid lipofuscin deposition. Affected individuals may suffer from blindness, pulmonary fibrosis, colitis, and bleeding diathesi...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0029-1220777
更新日期:2009-10-01 00:00:00