Medicine and Health Sciences Commons^™

Treatments For Opioid Use Disorder Among Pregnant And Reproductive-Aged Women., Dennis J. Hand, Vanessa L. Short, Diane J. Abatemarco

Department of Obstetrics and Gynecology Faculty Papers

The increased prevalence of opioid use disorder and access to medical insurance is subsequently increasing the likelihood that medical professionals will encounter individuals with opioid use disorder. Sharp increases in opioid use disorder among women mean that obstetricians, gynecologists, and other reproductive medicine providers may be especially likely to encounter such patients. Medical professionals' understanding of treatment for opioid use disorder and their roles in their patients' treatment may increase referrals to treatment, reduce stigma, and improve the quality of medical care. Treatment for opioid use disorder falls into four overlapping domains: medication management, medical care, behavioral/mental health care, and …

Cesarean In The Second Stage: A Possible Risk Factor For Subsequent Spontaneous Preterm Birth., Vincenzo Berghella, Alexis C. Gimovsky, Lisa D. Levine, Joy Vink

Department of Obstetrics and Gynecology Faculty Papers

No abstract provided.

Cervical Assessment By Ultrasound For Preventing Preterm Delivery., Vincenzo Berghella, Jason K. Baxter Md, Mscp, Nancy W Hendrix

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Measurement of cervical length (CL) by transvaginal ultrasound (TVU) is predictive of preterm birth (PTB). It is unclear if this screening test is effective for prevention of PTB.

OBJECTIVES: To assess the effectiveness of antenatal management based on transvaginal ultrasound of cervical length (TVU CL) screening for preventing PTB.

SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 August 2012), reviewed the reference lists of all articles and contacted experts in the field for additional and ongoing trials.

SELECTION CRITERIA: Published and unpublished randomized controlled trials including pregnant women between the gestational ages of 14 …

Common Respiratory Issues In Ambulatory Obstetrics., Kelly M Orzechowski, Richard C Miller

Department of Obstetrics and Gynecology Faculty Papers

This article reviews the diagnosis and management of the most common respiratory conditions complicating pregnancy--asthma and influenza. We also review strategies for smoking cessation in pregnancy as, in addition to exacerbating all other pulmonary conditions, smoking is the most modifiable risk factor for poor pregnancy outcome. Moreover, the obstetrician frequently encounters each of these conditions in the ambulatory setting. A thorough knowledge of the normal pregnancy-induced physiological respiratory changes combined with a comprehensive understanding of how to manage these conditions, will provide the obstetrician with the armamentarium needed to optimize health outcomes for mothers and their fetuses.

Cryptococcosis Of The Upper Genital Tract., Manish Gopal, Stacy Mccrosson, Pamela Edmonds, Thomas Klein

Department of Obstetrics and Gynecology Faculty Papers

Upper genital tract infection by Cryptococcus neoformans has not previously been reported. We describe such a case, in order to alert clinicians to the existence of this rare infection. A 34-year-old woman with AIDS presented with chronic menorrhagia, fever, anemia, and thrombocytopenia. Despite blood transfusions and hormonal therapy, her vaginal bleeding could not be controlled and she became hemodynamically unstable. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed, at which time granulomatous peritonitis and prominent myometrial blood vessels were found. Histologic examination revealed cryptococcal infection of all upper genital organs. This case demonstrates that disseminated cryptococcosis may involve the upper …

Predicting Length Of Treatment For Neonatal Abstinence Syndrome In Methadone-Exposed Neonates., Neil S. Seligman, Nicole Salva, Edward J. Hayes, Kevin C. Dysart, Edward C. Pequignot, Jason K. Baxter

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: The objective of the study was to identify maternal variables predicting length of treatment for neonatal abstinence syndrome (NAS).

STUDY DESIGN: This was a retrospective cohort study of infants treated for NAS during 2000-2006 whose mothers were on methadone maintenance at delivery. Mixed-effects linear regression was used to examine the interaction of maternal and neonatal variables with length of treatment.

RESULTS: Of 204 neonates born to methadone exposed mothers, the average dose at delivery was 127 mg daily (25-340 mg) with median length of treatment 32 days (1-122 days). Trimester of initial exposure (P = .33), methadone dose at …

Determinants Of Antepartum Human Immunodeficiency Virus Testing In A Non-Medicaid Obstetric Population., E Cardonick, S Daly, M Dooley, K Elles, N S Silverman

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: To determine voluntary human immunodeficiency virus (HIV) testing rates and factors influencing testing in a private obstetric practice.

METHODS: Antepartum patients were offered HIV testing after completing a self-assessment questionnaire. Perceived risks and demographics were correlated with testing rates.

RESULTS: Overall, 348/600 (58%) women consented to HIV testing. In a univariate analysis, patients with "any" perceived risk(s) were more likely to be tested. Single women and those with an at-risk partner(s) or a history of sexually transmitted disease (STD) were more likely to desire testing. These factors remained independently associated with voluntary testing in a multivariate regression model. No …

Initial Multicenter Experience With Double Nucleoside Therapy For Human Immunodeficiency Virus Infection During Pregnancy., N S Silverman, D H Watts, J Hitti, D M Money, E Livingston, J Axelrod, J M Ernest, D Robbins, M M Divito

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: To study maternal and neonatal effects of combination nucleoside analog therapy administered to human immunodeficiency virus (HIV)-infected pregnant women for maternal indications.

METHODS: A multicenter, prospective observational study was undertaken at six perinatal centers in the United States and Canada that supported regional referral programs for the treatment of HIV-infected pregnant women. Demographic, laboratory, and pregnancy outcome data were collected for 39 women whose antiretroviral treatment regimens were expanded to include more than one nucleoside analog for maternal indications. The 40 newborns were monitored at pediatric referral centers through at least three months of age to ascertain their HIV …