Re: Does hypochorionic hemorrhage alters triplo-test results?'reply'
From: art fougner, md (evsono@pipeline.com)
Thu Apr 1 11:47:07 2004
But how were the maternal serum screens specifically affected by
"threatened miscarriage"?
art
At Wed, 31 Mar 2004, AFPPLUS3@aol.com wrote:
>
>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. Bal ,
>MD,
>David A. Nyberg, MD, Christine H. Comstock, MD, Gary D. Hankins, MD, Richar
>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 pregnanc
>outcome.
>Study design: A large prospective multicenter database was studied. Subject
>were divided into three groups: (1) no bleeding, (2) light bleeding, and (3
>heavy bleeding. Univariate and multivariable logistic regression analyses w re
>used.
>Results: The study comprised 16,506 patients: 14,160 patients without
>bleeding, 2094 patients with light bleeding, and 252 patients with heavy bl eding.
>Patients with vaginal bleeding, light or heavy, were more likely to experie ce 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. ).
>Heavy vaginal bleeding subjects were more likely to have intrauterine growt
>restriction (odds ratio, 2.6), preterm delivery (odds ratio, 3.0), preterm
>premature rupture of membranes (odds ratio, 3.2), and placental abruption ( dds
>ratio, 3.6).
>Conclusion: First-trimester vaginal bleeding is an independent risk factor
>for adverse obstetric outcome that is directly proportional to the amount o
>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% o
>25% of all pregnancies.1,2 When pregnant patients have bleeding, it may cau e
>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 oted at
>ultrasound examination after first-trimester vaginal bleeding, 95% to 98% o
>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.
>
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--
art fougner, md
ich bin ein New Yorker
