Faculty Bibliography
Searched for:
in-biosketch:true
person:romana02
Total Results:
168
MSAFP does not improve detection rate for open neural tube defects in patients who receive first- and early second-trimester ultrasounds for fetal anatomical survey [Meeting Abstract]
ISI:000313393500360
ISSN: 0002-9378
CID: 221752
Twin pregnancy in patients with a uterine malformation [Meeting Abstract]
ISI:000313393500518
ISSN: 0002-9378
CID: 221762
Biochemical screening for aneuploidy in patients with donor oocyte pregnancies compared with autologous pregnancies [Meeting Abstract]
ISI:000313393500601
ISSN: 0002-9378
CID: 221802
Ultrasound-indicated cerclage: Shirodkar vs. McDonald
Objective: To compare the efficacy of Shirodkar to McDonald cerclage in patients with singleton pregnancies undergoing an ultrasound-indicated cerclage. Methods: Historical cohort of all patients with singleton pregnancies undergoing cerclage for the indication of a short cervix on ultrasound (ultrasound indicated) at one institution in 2005-2010. We compared outcomes based on cerclage type, Shirodkar or McDonald. Outcome measures were gestational age (GA) at delivery, delivery >/=35 weeks, >/=32 weeks, and PPROM. Multivariable regression analysis was performed to control for significant variables. Results: Seventy-four patients with singleton pregnancies underwent an ultrasound-indicated cerclage in the study period (47 Shirodkar, 27 McDonald). Shirodkar was associated with later GA at delivery (mean GA at delivery 36.98 +/- 3.39 vs. 33.34 +/- 6.37 weeks, p = 0.006), a higher likelihood of delivering >/=35 weeks (83 vs. 55.6%, p = 0.011) and >/=32 weeks (91.5 vs. 59.3%, p = 0.001), and a lower likelihood of preterm premature rupture of membrane (PPROM) (13.0 vs. 46.2%, p = 0.002). On adjusted analysis controlling for differing baseline characteristics, Shirodkar remained significantly associated with an increased incidence of delivery >/=32 weeks (odds ratio [OR]: 5.180, 95% CI: 1.024-26.205). Conclusion: Compared to the McDonald technique, the Shirodkar technique was more effective in prolonging pregnancy in patients with singleton pregnancies undergoing ultrasound-indicated cerclage. A prospective trial is needed to compare these two techniques.
PMID: 22873518
ISSN: 1476-4954
CID: 184772
Blood. 2012.DOI:
Safety of pk-guided iv bu CY VP-16 preparative regimen prior to autologous hematopoietic stem cell transplantation for lymphoma: Findings from a multi-center phase ii study in north america [Meeting Abstract]
EMBASE:70960406
ISSN: 0006-4971
CID: 217172
Journal of maternal-fetal & neonatal medicine. 2012:25(11):2308-11.DOI: 10.3109/14767058.2012.691579
Combined fetal fibronectin and cervical length and spontaneous preterm birth in asymptomatic triplet pregnancies
OBJECTIVE: To estimate the association between fetal fibronectin (fFN), cervical length (CL), and spontaneous preterm birth (SPTB) in asymptomatic women with triplet pregnancies. STUDY DESIGN: A cohort of 39 consecutive women with triplet pregnancies managed in one Maternal-Fetal medicine practice from 2005-2011 was analyzed. Combined fFN and CL testing was performed every 2 weeks from 22-32 weeks. A short CL was defined as
PMID: 22563765
ISSN: 1476-4954
CID: 198442
Vaginal fetal fibronectin as a predictor of spontaneous preterm delivery in triplet gestations
Objective: To assess the diagnostic accuracy of vaginal fetal fibronectin (fFN) sampling for predicting preterm birth in asymptomatic women carrying triplet gestations. Methods: An historical cohort of patients carrying triplet gestations between 1998 and 2010 was identified from a single practice by chart review. All patients were screened with fFN testing at 2-3 week intervals from 22 weeks to 32 weeks of gestation. Outcomes evaluated were spontaneous preterm birth prior to 28, 30, and 32 weeks' gestation and delivery within 2 and 3 weeks of testing. Results: There were 56 pregnancies that met criteria for inclusion. For delivery prior to 30 weeks' gestation, the test had a sensitivity of 75%, a specificity of 85.4%, a positive predictive value of 46.2%, a negative predictive value of 95.3%, positive likelihood ratio of 5.13, and a negative likelihood ratio of 0.29 (p < 0.0001). For delivery within 3 weeks of a single fFN assessment, the test had a sensitivity of 53.3%, a specificity of 95.8%, a positive predictive value of 53.3%, a negative predictive value of 95.8%, positive likelihood ratio of 12.7 and negative likelihood ratio of 0.48 (p < 0.0001). Conclusion: Fetal fibronectin testing provides moderate to high prediction of spontaneous preterm birth in triplet gestations.
PMID: 22489752
ISSN: 1476-4954
CID: 179203
The effect of maternal obesity on pregnancy outcomes of women with gestational diabetes controlled with diet only, glyburide, or insulin
OBJECTIVE: To examine the effect of obesity on maternal and neonatal outcomes in women diagnosed with gestational diabetes mellitus (GDM) and managed with diet only, glyburide, or insulin. STUDY DESIGN: Women with singleton gestations enrolled for outpatient services diagnosed with GDM and without history of pregnancy-related hypertension at enrollment or in a prior pregnancy were identified in a database. Women with GDM controlled by diet only (n = 3918), glyburide (n = 873), or insulin without prior exposure to oral hypoglycemic agents (n = 2229) were included. Pregnancy outcomes were compared for obese versus nonobese women within each treatment group and also compared across treatment groups within the obese and nonobese populations. RESULTS: Within each treatment group, obesity was associated with higher rates of cesarean delivery, pregnancy-related hypertension, macrosomia, and hyperbilirubinemia (all p < 0.05). Higher rates of pregnancy-related hypertension and hyperbilirubinemia were observed in women receiving glyburide. CONCLUSION: Obesity adversely affects pregnancy outcome in women with GDM. Higher rates of pregnancy-related hypertension and hyperbilirubinemia were observed in pregnant women receiving glyburide.
PMID: 22644829
ISSN: 0735-1631
CID: 779662
Induction of labor in twin compared with singleton pregnancies
OBJECTIVE: : To estimate the likelihood of cesarean delivery and length of labor in twin pregnancies undergoing induction of labor as compared with singleton pregnancies. METHODS: : This was a retrospective cohort study of 100 patients with twin pregnancy in one maternal-fetal medicine practice undergoing induction of labor from 2005 to 2012. The control group was 100 randomly selected patients in the same practice with a singleton pregnancy undergoing induction of labor over the same time period. The primary outcome was mode of delivery (vaginal or cesarean). RESULTS: : The likelihood of cesarean delivery did not differ between the groups (19% in twins compared with 21% in singletons, P=.724) nor did the time from induction to vaginal delivery (median and interquartile time 9.7 [5.5-12.5] hours in twins compared with 10.4 [6.6, 14.1] hours in singletons, P=.255). Results were not different when we looked at nulliparous patients only or multiparous patients only. On adjusted analysis of risk factors for cesarean delivery in patients undergoing induction, twin pregnancy was not independently associated with cesarean delivery. CONCLUSION: : Patients with twin pregnancies undergoing induction of labor have a similar risk of cesarean delivery and a similar length of labor as patients with singleton pregnancies undergoing induction of labor. LEVEL OF EVIDENCE: : II.
PMID: 22825088
ISSN: 0029-7844
CID: 174084
Persistence of placenta previa in twin gestations based on gestational age at sonographic detection
OBJECTIVES: The purpose of this study was to evaluate the gestational age at sonographic detection of placenta previa as a predictor of previa persistence until delivery in twin gestations. METHODS: A retrospective cohort of twin pregnancies with placenta previa in a single ultrasound unit was analyzed from 2005 to 2010. Pregnancies were ascertained from a database. Diagnoses were confirmed by transvaginal imaging. Previa was categorized as complete if the placenta completely covered the internal os or marginal if the inferior placental edge reached within 2 cm. Gestational ages were grouped into intervals from 15 to 35 weeks. The study outcome was placenta previa at delivery. Only twin pregnancies at 25 weeks' gestation and later were analyzed using nonparametric statistics as appropriate, with P < .05 as significant. RESULTS: Placenta previa was detected in 120 twin pregnancies in the second trimester: 32 complete and 88 marginal. Of those with placenta previa at 15 to 19, 20 to 23, 24 to 27, 28 to 31, and 32 to 35 weeks, previa persisted until delivery in 8.3%, 19.2%, 50%, 75%, and 92.5%, respectively. Only at 15- to 19- and 20- to 23-week intervals was complete previa more likely to persist than marginal previa (P < .001). CONCLUSIONS: The likelihood of placenta previa persistence in twins is dependent on the gestational age at sonographic detection. Only at earlier gestations does the type of previa affect its persistence. As gestational age advances, the likelihood of resolution of placenta previa diminishes regardless of the type noted.
PMID: 22733846
ISSN: 0278-4297
CID: 778442
