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 study from 2010 to 2012, comparing those who needed transfusion postpartum and those who did not. EBL, calculated EBL (cEBL), and change in hematocrit were calculated for patients who did not receive transfusion, and EBL was calculated for those who did receive transfusion, stratified by delivery type. Receiver operator curves were created and optimal thresholds of EBL to predict transfusion were estimated. RESULTS:Among 4,804 patients, transfusion was required for 0.65% of vaginal and 8.7% of cesarean deliveries. Median EBL was higher in women requiring transfusion. A weak correlation was noted between EBL and cEBL for all deliveries. Thresholds of 500 mL blood loss for vaginal delivery and 1,000 mL for cesarean had the best predictive ability for transfusion. CONCLUSION:In this modern obstetric, cohort EBL is weakly correlated with cEBL, suggesting that accuracy of clinical estimates of blood loss is modest. However, EBL predicts need for transfusion, with optimal thresholds of 500 mL for a vaginal delivery and 1,000 mL in a cesarean. This validates the traditional definitions of PPH in our modern population.
journal_name
Am J Perinatoljournal_title
American journal of perinatologyauthors
Conner SN,Tuuli MG,Colvin R,Shanks AL,Macones GA,Cahill AGdoi
10.1055/s-0035-1552940subject
Has Abstractpub_date
2015-11-01 00:00:00pages
1225-30issue
13eissn
0735-1631issn
1098-8785journal_volume
32pub_type
杂志文章abstract:OBJECTIVE:To identify single nucleotide polymorphisms (SNPs) associated with clinical chorioamnionitis among preterm infants. STUDY DESIGN:We reanalyzed a genome-wide association study (GWAS) from preterm newborns at less than 30 weeks' gestation. Cases and control definitions were determined using administrative reco...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1677503
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:Preterm infants are at risk of encountering oral feeding difficulties which impede on the transition to independent oral feeds. The objective of this study was to identify a pivotal period where regressions are most likely to occur during their oral feeding progression. STUDY DESIGN:This is a retrospective s...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1669947
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVE:Amplitude-integrated electroencephalography (aEEG) is a simplified method for continuous monitoring of brain activity in the neonatal intensive care unit (NICU). Our objective was to describe current aEEG use in the United States. STUDY DESIGN:An online survey was distributed to the American Academy of Pedia...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0034-1395483
更新日期:2015-07-01 00:00:00
abstract::Objective To determine if mandatory online training in electronic fetal monitoring (EFM) improved agreement in documentation between obstetric care providers and nurses on labor and delivery. Methods Health care professionals working in obstetrics at our institution were required to complete a course on EFM interpreta...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0036-1572540
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVE:The Apgar score has been shown to have utility in predicting mortality in the extremely preterm infant in delivery hospital populations, where most mortality occurs within 12 hours of birth. We tested the hypothesis that the 5 minute Apgar score would remain associated with mortality in extremely preterm infa...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0035-1554803
更新日期:2015-11-01 00:00:00
abstract::We present a case of congenital parvovirus B19 infection in a term neonate manifested with isolated massive hydrothorax and mild anemia. Parvovirus B19 DNA was detected in maternal and neonatal blood as well as in pleural fluid despite lack of suggestive serology. ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0028-1085621
更新日期:2008-10-01 00:00:00
abstract::The objective of this article is to prospectively investigate the efficacy of amnioinfusion as a means to reduce febrile morbidity in pregnancies complicated by chorioamnionitis. All laboring patients with a temperature > or =100.1 degrees F were approached for study participation. Exclusion criteria included amnionit...
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-2007-994085
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study is to evaluate the impact of multiple pregnancies, maternal obesity, and preeclampsia on the effect of antenatal steroids on neonatal respiratory distress syndrome (RDS). STUDY DESIGN:The retrospective cohort study was performed in a level III maternity ward. Population was composed of ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0035-1548537
更新日期:2015-09-01 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:OBJECTIVES:Widened pulse pressure is generally associated with patent ductus arteriosus (PDA). Surprisingly, this is often not true for preterm infants during the first week of life when systolic and diastolic pressures are both reduced and pulse pressure may remain unchanged. STUDY DESIGN:This is a retrospective, obs...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1677475
更新日期:2019-11-01 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::We sought (1) to identify risk factors for meconium aspiration syndrome (MAS) among infants born to women whose labors were complicated by thick-consistency meconium-stained amniotic fluid (MSAF), and (2) to determine whether risk factors and infant prognosis differ according to the time of onset of respiratory distre...
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-0029-1241740
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:To determine the risk of spontaneous preterm delivery (SPTD) associated with transvaginal cervical length (TVCL) in an unselected cohort. STUDY DESIGN:This is a retrospective study of serial TVCLs in unselected twin gestations. Receiver operator curves for SPTD were constructed from TVCLs at 18, 20, 22, and ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1676484
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:To determine epidemiology and clinical characteristics of infants with methicillin-susceptible (MSSA) and -resistant Staphylococcus aureus (MRSA) in a level III neonatal intensive care unit (NICU). STUDY DESIGN:All NICU admissions (2001 to 2008) with any positive S. aureus culture were included as cases. Cas...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0032-1304819
更新日期:2012-06-01 00:00:00
abstract::A previously healthy multigravida woman presenting with pyrexia was found to be pancytopenic at 32 weeks' gestation. The leukopenia and the thrombocytopenia responded to supportive therapy. The anemia, which was Coombs' negative, continued and was associated with a drop in fibrinogen, but both eventually returned to n...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994758
更新日期:1993-09-01 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::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:INTRODUCTION:Although guidelines recommend repeat ultrasound in the setting of an incomplete fetal anatomic survey, the clinical utility of this practice has not been established. As such, we aimed to assess the yield of repeat ultrasound for anomaly detection following an incomplete survey. MATERIALS AND METHODS:This...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1626715
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE: The acylcarnitine profile is analyzed in dried blood spots (DBS) to screen for inborn errors of metabolism. Hematocrit (Ht) is known to affect the result of quantitative analyses of DBS samples; however, the effects of Ht on the acylcarnitine profiles in DBS have not been studied in actual samples from newbo...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1721849
更新日期:2020-12-29 00:00:00
abstract::We examined the frequency with which congenital heart disease (CHD) and cytogenetic abnormalities were found associated with omphalocele, gastroschisis, duodenal atresia and posterior diaphragmatic hernias. We performed fetal echocardiograms on 80 patients with these diagnoses and found congenital heart disease in 13 ...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-2007-999427
更新日期:1991-11-01 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::We describe a case of transient hyperinsulinism in an asphyxiated newborn infant with hypoglycemia. Although hypoglycemia in birth asphyxiated infants is generally attributed to depletion of glycogen stores, we observed severe hyperinsulinism associated with the hypoglycemia. The hypoglycemia was refractory to high gl...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2001-15504
更新日期:2001-06-01 00:00:00
abstract::This investigation was undertaken to determine whether histologic examination of the placenta contributed to a better understanding of the cause of intrauterine fetal growth retardation. Placentas were examined of 151 liveborn infants whose birthweights were in the lower 10th percentile for gestational age. One or mor...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999546
更新日期:1989-01-01 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: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::Periventricular leukomalacia (PVL) is a complication of prematurity that carries a high risk of long-term neurologic morbidity. We report the first case, to our knowledge, of unexpected PVL associated with in utero methamphetamine exposure in a 30-week gestation premature infant with a benign hospital course, who subs...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-970079
更新日期:2007-02-01 00:00:00
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 c...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1715846
更新日期:2020-08-30 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: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 presence of the maternal warm antibody in pregnancy should not be ignored. As there is risk of both maternal and fetal anemia, both patients need to be followed for the development of such. Serial complete blood counts in the mother and treatment if significant fetal anemia develops should be considered. Serial am...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994196
更新日期:1996-01-01 00:00:00