|
|
 |
 |
 |
|
|
|||
|
||||
|
||||
Re: Does hypochorionic hemorrhage alters triplo-test results?"reply"From: AFPPLUS3@aol.comWed Mar 31 16:14:35 2004
This may help you with regards to adjusting the patients risk... Threatened abortion: A risk factor for poor pregnancy outcome, a population-based screening study Joshua L. Weiss, MD,* Fergal D. Malone, MD, John Vidaver, MA, Robert H. Ball, MD, David A. Nyberg, MD, Christine H. Comstock, MD, Gary D. Hankins, MD, Richard L. Berkowitz, MD, Susan J. Gross, MD, Lorraine Dugoff, MD, Ilan E. Timor-Tritsch, MD, Mary E. D’Alton, MD, for the FASTER Consortium Columbia Presbyterian Medical Center, New York, NY – Objective: The purpose of this study was to determine whether patients with first-trimester threatened abortion are at increased risk for poor pregnancy outcome. Study design: A large prospective multicenter database was studied. Subjects were divided into three groups: (1) no bleeding, (2) light bleeding, and (3) heavy bleeding. Univariate and multivariable logistic regression analyses were used. Results: The study comprised 16,506 patients: 14,160 patients without bleeding, 2094 patients with light bleeding, and 252 patients with heavy bleeding. Patients with vaginal bleeding, light or heavy, were more likely to experience a spontaneous loss before 24 weeks of gestation (odds ratio, 2.5 and 4.2, respectively) and cesarean delivery (odds ratio, 1.1 and 1.4, respectively). Light bleeding subjects were more likely to have preeclampsia (odds ratio, 1.5), preterm delivery (odds ratio, 1.3), and placental abruption (odds ratio, 1.6). Heavy vaginal bleeding subjects were more likely to have intrauterine growth restriction (odds ratio, 2.6), preterm delivery (odds ratio, 3.0), preterm premature rupture of membranes (odds ratio, 3.2), and placental abruption (odds ratio, 3.6). Conclusion: First-trimester vaginal bleeding is an independent risk factor for adverse obstetric outcome that is directly proportional to the amount of bleeding. 2004 Elsevier Inc. All rights reserved. KEY WORDS Threatened abortion Spontaneous pregnancy loss Preterm delivery Placental abruption Preterm premature rupture of membranes – First-trimester vaginal bleeding is a common complication that affects 16% to 25% of all pregnancies.1,2 When pregnant patients have bleeding, it may cause stress and anxiety for the mother-to-be about the future outcome of the pregnancy. In general, the incidence of spontaneous abortion after first-trimester bleeding is quoted to be 50% before sonographic evaluation for fetal viability.1,3 If a viable fetus is noted at ultrasound examination after first-trimester vaginal bleeding, 95% to 98% of such pregnancies will still continue beyond 20 weeks of gestation.1,4 Supported by grant No. RO1 HD 38652 from the National Institutes of Health and the National Institute of Child Health and Human Development. * Reprint requests: Joshua L. Weiss, MD, Columbia Presbyterian Medical Center, 622 W 168th St, PH-16-66, New York, NY 10032. E-mail: jw791@columbia.edu http://www.elsevier.com/locate/ajog American Journal of Obstetrics and Gynecology (2004) 190, 745-50 Leonard H. Kellner Lenetix Medical Screening Laboratory, Inc. CONFIDENTIALITY NOTICE: This email contains information from the sender that may be confidential, legally privileged, proprietary or otherwise protected from disclosure. This email is intended for use only by the person or entity to whom it is addressed. If you are not the intended recipient or the person responsible for delivering this e-mail to the intended recipient, any use, disclosure, copying, distribution, or printing of the contents of this email is strictly prohibited. If you received this email in error, please inform the sending party by an e-mail reply, delete the email from your computer system and shred any paper copies of the email.
|
|
Return to
|
Mail a New Message to the Forum: ultrasound@obgyn.net Forum Administrator: terry.dubose@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Thu Oct 2 05:19:32 2008 |
The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.