The Experts below are selected from a list of 54 Experts worldwide ranked by ideXlab platform
George A Macones - One of the best experts on this subject based on the ideXlab platform.
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active management of risk in pregnancy at term in an urban population an association between a higher induction of Labor Rate and a lower cesarean delivery Rate
American Journal of Obstetrics and Gynecology, 2004Co-Authors: James M Nicholson, Lisa C Kellar, Peter F Cronholm, George A MaconesAbstract:Objective The purpose of this study was to determine whether exposure to an alternative method of care, called the active management of risk in pregnancy at term, was associated with a lower group cesarean delivery Rate. Study design Active management of risk in pregnancy at term used risk factors for cesarean delivery to guide an increased use of Labor induction. A retrospective cohort design was used to compare clinical outcomes of 100 pregnant women who were exposed to active management of risk in pregnancy at term to 300 randomly selected subjects who received standard management. Results The 2 groups had comparable levels of prenatal risk. The group exposed to the active management of risk in pregnancy at term exposure group encountered a higher induction Rate (63% vs 25.7%; P P =.01). Findings were similar for both nulliparous and multiparous subgroups. Active management of risk in pregnancy at term exposure was not associated with higher Rates of other major birth outcomes. Conclusion Exposure to the active management of risk in pregnancy at term exposure was associated with a significantly lower group cesarean delivery Rate. A prospective randomized trial that involved active management of risk in pregnancy at term exposure is needed to further explore this association.
Sailesh Kumar - One of the best experts on this subject based on the ideXlab platform.
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early procedure related complications of fetal blood sampling and intrauterine transfusion for fetal anemia
Acta Obstetricia et Gynecologica Scandinavica, 2012Co-Authors: Carina Johnstoneayliffe, T Prior, Fiona Regan, Sailesh KumarAbstract:Objective. To review the procedure-related complication Rates following fetal blood sampling and intrauterine red cell transfusion for anaemic fetuses at a single tertiary center. Design. A retrospective study of 114 intrauterine transfusions. Setting. A single tertiary referral fetal medicine center at Queen Charlotte's and Chelsea Hospital, Imperial College London, London, UK. Sample. All cases (114) undergoing fetal blood sampling and intrauterine transfusion between January 2003 and May 2010. Methods. Early procedure-related complications (severe fetal bradycardia requiring either abandonment of the procedure or emergency delivery, fetal death, preterm Labor or rupture of membranes) were investigated by review of computerized records and individual chart review. Main outcome measures. Live birth Rate, perinatal mortality, procedure-related fetal bradycardia, preterm Labor and procedure-related spontaneous rupture of membranes. Results. The majority of cases (77.8%) were due to red cell alloimmunization, with anti-D being the commonest cause. The live birth Rate was 93.5%, with a procedure-related fetal death Rate of 0.9%. The preterm Labor Rate ( 3) fetal transfusions. Complications in this series did not appear to be increased the earlier the gestation at which the first transfusion took place. Conclusions. Despite a reduction in the number of cases requiring intrauterine therapy for fetal anemia, contemporary outcomes appear to be good if not improving. It is important that the experience required to manage these cases should be concentRated in fewer centers to maximize good perinatal outcome.
Everett F Magann - One of the best experts on this subject based on the ideXlab platform.
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maternal and perinatal complications with uterine rupture in 142 075 patients who attempted vaginal birth after cesarean delivery a review of the literature
American Journal of Obstetrics and Gynecology, 2003Co-Authors: Suneet P Chauhan, James N Martin, Christine E Henrichs, J C Morrison, Everett F MagannAbstract:Abstract OBJECTIVE: The purpose of this study was to determine the Rate of uterine rupture and its complications as the result of trial of Labor after previous cesarean delivery. STUDY DESIGN: PubMed was searched from 1989 to 2001, with the terms “VBAC, uterine rupture,” “trial of Labor, uterine rupture,” “cesarean delivery, uterine rupture,” and “scarred uterus, rupture.” For inclusion, reports had to contain data from at least 100 patients with trials of Labor that included a description of adverse outcomes. Duplicate reporting from a single institution was excluded. Odds ratios and 95% CIs were calculated. RESULTS: Seventy-two of the 361 articles (20%) that were identified met the inclusion criteria. A 6.2 per 1000 trial of Labor Rate of uterine rupture (total = 880 uterine ruptures in 142,075 trials of Labor) was determined. For every 1000 trials of Labor the uterine rupture-related complication Rate was 1.8 for packed red blood cell transfusion, 1.5 for pathologic fetal acidosis (cord pH CONCLUSION: Although relatively uncommon, uterine rupture is associated with several adverse outcomes, depending on the time of the publication and the site and size of the population that was studied.
Veena Mathur - One of the best experts on this subject based on the ideXlab platform.
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A comparative clinical study of intrathecal bupivacaine 2.5 mg with dexmedetomidine 5 μg versus intrathecal bupivacaine 2.5 mg with fentanyl 25 μg on the duration of Labor analgesia using combined spinal epidural technique
Wolters Kluwer Medknow Publications, 2019Co-Authors: Neena Jain, Pooja R Mathur, Poorva Soni, Veena Patodi, Surendra K Sethi, Veena MathurAbstract:Context: Adjuvants may be added to decrease motor blockade caused by intrathecal bupivacaine and prolong Labor analgesia. Aim: To study the effect of intrathecal dexmedetomidine versus fentanyl when added to bupivacaine on the duration of Labor analgesia, progress of Labor, block characteristics, and side effects. Settings and Design: A prospective, randomized double-blind study. Materials and Methods: Sixty parturients consenting for Labor analgesia were divided into two groups. Group A (n = 30) received an intrathecal 0.5% hyperbaric bupivacaine 2.5 mg and dexmedetomidine 5 μg and Group B (n = 30) received an intrathecal 0.5% hyperbaric bupivacaine 2.5 mg and fentanyl 25 μg. Partogram, visual analog score, sensory and motor blockage, progress of Labor, maternal hemodynamic variations, and fetal heart Rate were noted. Statistical Analysis Used: Standard qualitative and quantitative tests were used to compare data (e.g., unpaired student t-test, ANOVA, Chi-square); P value of 0.05 was considered significant. Results: Duration of Labor analgesia was significantly greater in Group A as compared to Group B (254.17 ± 4.75 min vs. 123.67 ± 6.01 min, P < 0.0001). Mean onset of analgesia was earlier in Group A as compared to Group B (1.27 ± 0.37 min vs. 3.27 ± 0.37 min, P < 0.0001). Duration of the active phase of the first and second stages of Labor, Rate of cervical dilation, hemodynamic and side effects profile, and neonatal outcome were comparable in both groups (P > 0.05)
James M Nicholson - One of the best experts on this subject based on the ideXlab platform.
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active management of risk in pregnancy at term in an urban population an association between a higher induction of Labor Rate and a lower cesarean delivery Rate
American Journal of Obstetrics and Gynecology, 2004Co-Authors: James M Nicholson, Lisa C Kellar, Peter F Cronholm, George A MaconesAbstract:Objective The purpose of this study was to determine whether exposure to an alternative method of care, called the active management of risk in pregnancy at term, was associated with a lower group cesarean delivery Rate. Study design Active management of risk in pregnancy at term used risk factors for cesarean delivery to guide an increased use of Labor induction. A retrospective cohort design was used to compare clinical outcomes of 100 pregnant women who were exposed to active management of risk in pregnancy at term to 300 randomly selected subjects who received standard management. Results The 2 groups had comparable levels of prenatal risk. The group exposed to the active management of risk in pregnancy at term exposure group encountered a higher induction Rate (63% vs 25.7%; P P =.01). Findings were similar for both nulliparous and multiparous subgroups. Active management of risk in pregnancy at term exposure was not associated with higher Rates of other major birth outcomes. Conclusion Exposure to the active management of risk in pregnancy at term exposure was associated with a significantly lower group cesarean delivery Rate. A prospective randomized trial that involved active management of risk in pregnancy at term exposure is needed to further explore this association.
