Journal Of Obstetrics Research Articles

Prediction of obstetrical and fetal complications using automated electronic health record data

An increasing number of delivering women experience major morbidity and mortality. Limited work has been done on automated predictive models that could be used for prevention. Using only routinely collected obstetrical data, this study aimed to develop a predictive model suitable for real-time use with an electronic medical record. We used a retrospective cohort study design with split validation. The denominator consisted of women admitted to a delivery service. The numerator consisted of women who experienced a composite outcome that included both maternal (eg, uterine rupture, postpartum hemorrhage), fetal (eg, stillbirth), and neonatal (eg, hypoxic ischemic encephalopathy) adverse events. We employed machine learning methods, assessing model performance using the area under the receiver operator characteristic curve and number needed to evaluate. A total of 303,678 deliveries took place at 15 study hospitals between January 1, 2010, and March 31, 2018, and 4130 (1.36%) had ≥1 obstetrical complication. We employed data from 209,611 randomly selected deliveries (January 1, 2010, to March 31, 2017) as a derivation dataset and validated our findings on data from 52,398 randomly selected deliveries during the same time period (validation 1 dataset). We then applied our model to data from 41,669 deliveries from the last year of the study (April 1, 2017, to March 31, 2018 [validation 2 dataset]). Our model included 35 variables (eg, demographics, vital signs, laboratory tests, progress of labor indicators). In the validation 2 dataset, a gradient boosted model (area under the receiver operating characteristic curve or c statistic, 0.786) was slightly superior to a logistic regression model (c statistic, 0.778). Using an alert threshold of 4.1%, our final model would flag 16.7% of women and detect 52% of adverse outcomes, with a number needed to evaluate of 20.9 and 0.455 first alerts per day per 1000 annual deliveries. In conclusion, electronic medical record data can be used to predict obstetrical complications. The clinical utility of these automated models has not yet been demonstrated. To conduct interventions to assess whether using these models results in patient benefit, future work will need to focus on the development of clinical protocols suitable for use in interventions.

Chronic Pelvic Pain in Women with a History of Essure Placement: A Systematic Review of Differential Diagnosis and Management Options

Study Objective The purpose of this article is to provide an evidence based review of management options for patients with pelvic pain and an in situ Essure device. Design Literature review and qualitative analysis. Setting N/A Patients or Participants N/A Interventions N/A Measurements and Main Results The Essure device was voluntarily withdrawn from the market in 2018 by the manufacturer due in part to concerns about post placement adverse events and an FDA black box warning about uterine and fallopian tube perforation, suspected allergic or hypersensitivity reaction, and need for surgical removal for adverse events which were mostly related to pain. We performed a PubMed keyword literature search, as well as directed searches of Obstetrics & Gynecology, American Journal of Obstetrics and Gynecology, and Journal of Minimally Invasive Gynecology. A total of 43 publications were included, and consisted of 7 prospective studies, 15 retrospective studies, 18 case series, 2 review articles, and one summary article by the FDA. Conclusion A brief summary of recommendations and conclusions from this review: - Initial work up of pain in a patient with Essure devices should begin with placement confirmation via either transvaginal ultrasound or hysterosalpingogram/Xray. - In the event Essure microinserts are malpositioned, device removal is recommended. - In patients with a history and physical exam suggestive of possible endometriosis or adenomyosis, consider an attempt at hormonal management prior to surgical excision of the Essure device. - We recommend a laparoscopic resection of the fallopian tubes with or without partial coronuectomy for the management of pelvic pain of and no other identifiable source, even if Essure device is positioned appropriately. - We recommend an imaging modality be available in the OR during device removal to confirm an intact device and/or complete resection. - If hysterectomy is planned for in patients with the Essure device for indications other than pelvic pain, we recommend en block resection of the fallopian tubes and cornua.

Clinical Risk Factors for COVID-19 Among People With Substance Use Disorders.

Back to table of contents Previous article Next article DatapointsFull AccessClinical Risk Factors for COVID-19 Among People With Substance Use DisordersHefei Wen, Ph.D., Michael L. Barnett, M.D., M.S., Brendan Saloner, Ph.D.Hefei WenSearch for more papers by this author, Ph.D., Michael L. BarnettSearch for more papers by this author, M.D., M.S., Brendan SalonerSearch for more papers by this author, Ph.D.Published Online:6 Oct 2020https://doi.org/10.1176/appi.ps.202000215AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail As COVID-19 spreads across the United States, people with substance use disorder may be susceptible to contracting the disease and developing serious complications. COVID-19 epidemiology suggests that cardiovascular and chronic respiratory diseases and diabetes may increase the risk for severe illness (1). People with opioid use disorder and methamphetamine use disorder deserve particular attention, given the detrimental effects of long-term drug use on pulmonary function, other major organ systems, and the immune system (1).We used individual‐level data from the 2015–2018 National Survey on Drug Use and Health (NSDUH). Our sample consisted of three mutually exclusive groups of civilian, noninstitutionalized adults ages 18–64: those with past-year opioid or methamphetamine use disorder, those with other types of past-year substance use disorder (i.e., abuse of or dependence on alcohol, illicit drugs other than opioid and methamphetamine, or both), and those who did not have a past-year substance use disorder (2).We used logistic regression models to estimate differences among the groups in the overall and age-stratified rates of having an underlying condition that may heighten the risk for severe illness following COVID-19 infection. Models were adjusted for gender, race-ethnicity, and urban/rural residence. We used the Stata/SE “svy” procedure to account for NSDUH’s sampling weights and complex survey design (2).Nonelderly adults with opioid or methamphetamine use disorder were most likely to have an underlying condition (adjusted rate, 44.2%; p<0.001), compared with those with other types of substance use disorder (31.4%) and those without a past-year substance use disorder (33.5%). The higher rates of having an underlying condition among those with opioid or methamphetamine use disorder were observed consistently across all age categories (Figure 1).FIGURE 1. Adjusted rates of having clinical risk factors for COVID-19 severity and mortality among nonelderly U.S. adultsaaClinical risk factors recognized by the World Health Organization and the Centers for Disease Control and Prevention and included in the National Survey on Drug Use and Health questionnaire are cardiovascular disease, hypertension, chronic respiratory diseases, diabetes, cancer, chronic liver diseases, kidney disease, and HIV/AIDS. Rate estimates and 95% confidence intervals (whisker lines) were estimated with Stata/SE.Our findings underscore that opioid and methamphetamine use disorders are associated with underlying conditions identified as risk factors for COVID-19 severity and mortality. People with these conditions are an underserved group who may need additional support to ensure equal access to testing and treatment, especially as COVID-19 continues to impose unprecedented pressures on the nation’s health care system. Social distancing, self-quarantine, and other public health measures may disrupt their access to addiction treatment (2). Additional efforts are required to mitigate those unintended disruptions.Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston (Wen); Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston (Barnett); Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore (Saloner). Tami L. Mark, Ph.D., and Alexander J. Cowell, Ph.D., are editors of this column.Send correspondence to Dr. Wen ([email protected]).The authors report no financial relationships with commercial interests.References1 Volkow ND. Collision of the COVID-19 and addiction epidemics. Ann Intern Med (Epub ahead of print, April 2, 2020).Crossref, Medline, Google Scholar2 2018 National Survey on Drug Use and Health: Methodological Summary and Definitions. Rockville, MD, Substance Abuse and Mental Health Services Administration, 2019. https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHMethodsSummDefs2018/NSDUHMethodsSummDefs2018.pdfGoogle Scholar FiguresReferencesCited byDetailsCited byBehavioral Health Workforce Development in the era of COVID-19: Examples From a State-Funded Intermediary Organization26 April 2022 | Community Mental Health Journal, Vol. 58, No. 8Experiences with substance use disorder treatment during the COVID-19 pandemic: Findings from a multistate surveyInternational Journal of Drug Policy, Vol. 101The Impact of the COVID-19 Pandemic on the Practice of Forensic Medicine: An Overview8 February 2022 | Healthcare, Vol. 10, No. 2Integrated vs nonintegrated treatment for perinatal opioid use disorder: retrospective cohort studyAmerican Journal of Obstetrics & Gynecology MFM, Vol. 4, No. 1Prevalence and correlates of SARS-CoV-2 seropositivity among people who inject drugs in the San Diego-Tijuana border region22 November 2021 | PLOS ONE, Vol. 16, No. 11 Volume 71Issue 12 December 01, 2020Pages 1308-1308 Metrics Keywordssubstance use disorderCOVID-19chronic diseaserisk factorPDF download History Received 2 April 2020 Revised 19 April 2020 Accepted 13 May 2020 Published online 6 October 2020 Published in print 1 December 2020

Finding a Medical Home for Perinatal Depression: How Can We Bridge the Postpartum Gap?

Finding a Medical Home for Perinatal Depression: How Can We Bridge the Postpartum Gap?

Correspondence&#x0D; About the article of the Privat-docent V. F. Maslovkago: "To the doctrine of self-infection of maternity hospitals".

Privat-docent V. F. Maslovsky in his work "On the doctrine of self-infection of maternity hospitals", which appeared in the April book "Journal of obstetrics and women's diseases" for the current year, reproaches me for limiting myself to studying only the biological properties of microbes found, and says (p.332): "it is currently impossible to determine the property of microbes according to the state of culture, due to insufficient information about their biological properties."In this regard, I should note that it is the biological properties of known microbes that are currently being studied; in particular, this can be said about the desired microbe in my workstaph. R. aureus.

Meeting of obstetric and gynecological societies. Protocol No. IX. Administrative arrest 18 January 1895 (§ 34)

D.O. Ott chaired.23 members attended.1) The Chairman announced to those present that the Board decided to send out Mr. members of the Society amended 17 of the Charter, approved by the Government on February 22, 1894.2) The letter of the Kiev Obstetric and Gynecological Society has been read. (See protocol No. VIII, dated December 22, 1894).It was resolved: to accept the proposal of the named Society, however, it is limited so that the articles, even of the members of the Kiev Obstetric and Gynecological Society, but not reported to the family of the Society, are accepted by the editorial board of the "Journal of Obstetrics and Women's Diseases" on common basis.

Protocol No. VI. Administrative appointment on September 22, 1894

The chairman was D.O. Ott.20 members were present.Chitan and protocol No. V.D. Ott informed those present that on August 28, 1894, the Elisavetgrad Medical Society, on the occasion of the 25th anniversary of its existence, was sent the following congratulatory telegram: The Obstetric and Gynecological Society welcomes the Elisavetgrad Medical Society on the occasion of its 25 and wishes him success in the field of science and in the future. " O. Ott read the following copy of the proposal of the Medical Department of the Ministry of Internal Affairs, dated June 9, No. 4213. (See "Journal of Obstetrics and Women's Diseases", April 1894, p. 368).

Meeting of obstetric and gynecological societies. Protocol No. X. Administrative meeting on February 16, 1895

It was chaired by V. I. Stolts.1) Protocols Nos. VIII and IX were read and approved.2) The revision committee of the members of Goraiskaya, Zamshin and Frank reported to the Company that during the revision of the cash desk, the last one was found by them in full order.3) Revision commission from members of Eberman, Vasten and A.R. Fisher reported to the Society that the receipts and expenditures and, in general, all the bookkeeping of the editorial office of the "Journal of Obstetrics and Women's Diseases", for the expired 1894, were kept correctly. The reporting financial year, concluded with a cash balance in the size of two hundred sixty seven rubles 32 kopecks (267 rub. 32 kop.).

Prof. Howard A. Kelly. Resuscitation, from impeding death due to conceoled haemorrhage, by the infusion of a liter of normal soit solution centrally into the radial artery. (American Journal of Obstetrics and diseases of women and children, August, 1894, p. 184). Death threatening the parturient woman due to latent bleeding. Revitalize by infusing 1 liter of normal saline solution into

During the last ten months prof. Kelly saved the lives of six patients by injecting normal saline solution into the vessels, mainly the radial artery.

Dr. Goelet. Ligation of the base of the broadligaments per vaginam, including the uterine arteries, for fibroids of the uterus. (American Medico-Surgical Bulletin, Iune 1894, - by reference to the American Journal of Obstetrics, Iuli, 1894, p. 158). Ligation of the wide ligaments and uterine arteries from the side of the vagina to heal the fibroid of the uterus.

Goelet performs the aforementioned dressing in order to reduce bleeding and the growth of fibroid tumors of the uterus and believes that this easy operation can replace the more risky one - removal of the entire uterus, or that the first, serving as a preparatory phase for the 2nd, may make the latter unnecessary.

Dr. Charles N. Smith (in Toledo, Ohio). Total extirpation of the uterus for myofibroma complicated by pregnancy. American Journal of obstetrics and deseases of women and children. (September, 1894, p. 365., New-Iork). Removal of the entire uterus due to myofibroma complicated by pregnancy.

Patient 27 years old. Her 1st pregnancy ended safely 31/2 years ago, the 2nd - with a miscarriage at the 6th month, in February 1893.Since then she has been complaining of pain in the abdomen and feels in it some kind of body moving from one side to another. The last regulations were at the end of December 1893.

Prof. Howard A. Kell'y (Baltimore). Electric illumination of the Field in Abdominal Surgery. (The American Journal of Obstetrics and diseases of Women and children. September, 1894, p. 348). Electric lighting of the operating field for laparotomy

Those who perform laparotomy experience the inconvenience of insufficient illumination of the operating field, not only with artificial light, but also with daylight.

Prof. Paul. F. Munde. Ten Years ’experience with Alexander’s operation for schortening the round ligaments of the uterus — sixty-five cases. (American Journal of obstetrics and diseases of Women and children, 1894, August, p. 297). Ten years of experience with shortening of the round uterine ligaments (Alexander's operation), 65 cases.

Munde began to perform this operation in 1884. The results of the operation were so good that in the first year he performed it 6 times, and in 1888 he published 23 cases of it. In three of them M. did not find round ligaments, but in the remaining 20 the goal of the operation was achieved.

Insights from outside BJOG

BJOG: An International Journal of Obstetrics & GynaecologyVolume 127, Issue 11 p. 1313-1317 Insights from outside BJOG Insights from outside BJOG Athol Kent, Athol KentSearch for more papers by this authorShona Kirtley, Shona KirtleySearch for more papers by this author Athol Kent, Athol KentSearch for more papers by this authorShona Kirtley, Shona KirtleySearch for more papers by this author First published: 16 September 2020 https://doi.org/10.1111/1471-0528.16454 The Research Snippets are extracts from a monthly service called the Journal Article Summary Service. It is a service that summarises new articles in obstetrics and gynaecology published over the preceding month. If you would like information on how to subscribe, please email the editor Athol Kent at atholkent@mweb.co.za or visit the website www.getjass.com. The remaining sections of Insights from outside BJOG are written by Shona Kirtley, Senior Research Information Specialist, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Oxford, UK. This Insights from outside BJOG was edited by Makrina Savvidou, Consultant in Obstetrics and Fetal Medicine at Chelsea and Westminster Hospital and King's College Hospital in London, and BJOG Executive Scientific Editor. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume127, Issue11October 2020Pages 1313-1317 RelatedInformation

A NEW METHOD FOR ACCURATE PREDICTION OF SPERMATOGENESIS: FSH/T AND T IN SEMINAL PLASMA

A NEW METHOD FOR ACCURATE PREDICTION OF SPERMATOGENESIS: FSH/T AND T IN SEMINAL PLASMA

The old pregnancy calendar as a new invention

The author complements the article by R. Nickel, which appeared in No. 37 Cntrbl. f. Gyn. and indicating that the pregnancy calendar published in the American Journal of obstetrics (November 1889) and in the Archives de tocologie (May 1890) is far from new, as he found it in one of the Prussian textbooks published in 1838 or 1840

Revisiting vitamin D and home-based exercises for patients with sleep apnea facing the COVID-19 quarantine.

Citation:Ekiz T, Kara M, Ozcakar L. Revisiting vitamin D and home-based exercises for patients with sleep apnea facing the COVID-19 quarantine. J Clin Sleep Med. 2020;16(8):1409–1410.

Insights from outside BJOG

BJOG: An International Journal of Obstetrics & GynaecologyVolume 127, Issue 10 p. 1175-1179 Insights from outside BJOG Insights from outside BJOG Athol Kent, Athol KentSearch for more papers by this authorShona Kirtley, Shona KirtleySearch for more papers by this author Athol Kent, Athol KentSearch for more papers by this authorShona Kirtley, Shona KirtleySearch for more papers by this author First published: 13 August 2020 https://doi.org/10.1111/1471-0528.16409 The Research Snippets are extracts from a monthly service called the Journal Article Summary Service. It is a service that summarises new articles in obstetrics and gynaecology published over the preceding month. If you would like information on how to subscribe, please email the editor Athol Kent at atholkent@mweb.co.za or visit the website www.getjass.com. The remaining sections of Insights from outside BJOG are written by Shona Kirtley, Senior Research Information Specialist, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Oxford, UK. This Insights from outside BJOG was edited by Makrina Savvidou, Consultant in Obstetrics and Fetal Medicine at Chelsea and Westminster Hospital and King's College Hospital in London, and BJOG Executive Scientific Editor. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume127, Issue10September 2020Pages 1175-1179 RelatedInformation

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