Melissa C Bush

OBJECTIVE: To evaluate the long-term clinical significance of intrauterine hematomas detected in the first trimester of pregnancy in a general obstetric population.

METHODS: A prospective study was designed to compare perinatal outcomes in 187 pregnant women with intrauterine hematomas and 6488 controls in whom hematomas were not detected at first-trimester ultrasonographic examination.

RESULTS: The incidence of intrauterine hematoma in the first trimester in a general obstetric ...

OBJECTIVE: To estimate whether discordant growth is associated with adverse perinatal outcomes in twins after adjusting for growth restriction.

METHODS: This was a retrospective, hospital-based cohort study of twin gestations with 2 live births delivered at 24 weeks or later from 1992 to 2001. Twin gestations were classified as small for gestational age (SGA) if one or both infants was less than the 10th percentile at birth by singleton Brenner norms and discordant if there was a 20% or ...

OBJECTIVE: To evaluate pregnancy course, complications, and outcomes in liver transplant recipients.

METHODS: We conducted a retrospective review of 38 pregnancies conceived between 1992 and 2002 in 29 women who underwent liver transplantation at Mount Sinai Medical Center.

RESULTS: The most common primary liver disease was autoimmune hepatitis. All patients were on immunosuppressive regimens that included cyclosporine A or tacrolimus. There were four spontaneous first-trimester ...

OBJECTIVE: To compare the safety and efficacy of intravaginal misoprostol to oxytocin for the induction of labor in twin gestations.

METHODS: All twin gestations that underwent induction of labor with misoprostol or oxytocin during a 4-year period were identified from the Mount Sinai obstetrical database. Only twins > or = 34 weeks with a vertex presenting twin A were included. Labor and delivery characteristics, maternal complications and neonatal outcomes were compared between the two ...

OBJECTIVES: To compare the levels of pain and anxiety associated with amniocentesis (AC), transabdominal chorionic villus sampling (TA-CVS), and transcervical chorionic villus sampling (TC-CVS).

METHODS: We prospectively administered a questionnaire about pain and anxiety to 124 women undergoing AC, 40 undergoing TA-CVS, and 24 undergoing TC-CVS for singleton pregnancies. The level of pain was quantified with numerical and pictorial scales and the degree of anxiety was quantified with a ...

OBJECTIVE: To determine whether inflammatory bowel disease (IBD) is associated with increased risk for adverse perinatal outcome.

METHODS: A case-control study of 116 singleton pregnancies with IBD compared to 56,398 singleton controls delivered between 1986 and 2001.

RESULTS: Patients with IBD were slightly older (32.8 vs. 30.6 years, p < 0.001), more likely to be Caucasian or Asian than Black or Latino (92% vs. 57%, p < 0.001) and have private health insurance (33% vs. 3%, p < 0.001). ...

Severe maternal neurologic injury during pregnancy has the potential for fetal demise without advanced critical care support to the mother. Brain death is the unequivocal and irreversible loss of total brain function, whereas patients in a vegetative state, by contrast, have preserved brain stem function but lack cerebral function. They can appear to be awake, have sleep-wake cycles, be capable of swallowing, and have normal respiratory control, but there are no purposeful interactions. ...

OBJECTIVE: To explore women's attitudes and beliefs regarding cesarean delivery and cesarean delivery on maternal request (CDMR).

STUDY DESIGN: Anonymous questionnaires assessing patient demographics, knowledge, and attitudes about CDMR were distributed at the time of routine mid-trimester ultrasound appointment.

RESULTS: Eight hundred thirty three out of 3929 (21.2%) potential participants completed the questionnaire. About 81.7% of participants indicated that they believed that vaginal ...

OBJECTIVE: The purpose of this study was to define the indications and outcomes of emergent cesarean deliveries.

STUDY DESIGN: We analyzed prospectively collected singleton maternal and neonatal data from January 1, 1998, to December 31, 2004 of all such cesarean deliveries that were performed. A case-control analysis was performed by matching emergent cesarean deliveries with the next 2 acute cesarean deliveries.

RESULTS: There were 126 emergent cesarean deliveries (1:159 deliveries). ...

Objective:To assess maternal postpartum and neonatal outcomes associated with previous method of delivery.Study Design:We analyzed prospectively collected maternal and neonatal data from July 2002 to December 2003. Data were collected from dedicated perinatal database and neonatal database from discharge and procedure codes. Groups were: (i) multiparous, prior vaginal delivery (VD), and (ii) multiparous, prior cesarean (CS). This group was subdivided by subsequent pregnancy trial or no ...

MPR and ST are important options for patients who have multifetal pregnancies. Both procedures have been shown to be technically safe and result in acceptable pregnancy loss rates and GAs at delivery. An important caveat is that these findings are observed in centers that have vast experience performing this type of procedure and should not be generalized to all centers. The authors believe that the good outcomes reported here and elsewhere are a result of having a relatively limited ...