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73


The use of cervical sonography to differentiate true versus false labor in term gestations [Meeting Abstract]

Kunzier, Nadia; Kinzler, Wendy; Muscat, Jolene; Chavez, Martin; Vintzileos, Anthony
ISI:000330322600747
ISSN: 0002-9378
CID: 3444492

Patient acceptance of non-invasive testing for fetal aneuploidy via cell-free fetal DNA

Vahanian, Sevan A; Baraa Allaf, M; Yeh, Corinne; Chavez, Martin R; Kinzler, Wendy L; Vintzileos, Anthony M
OBJECTIVE: To evaluate factors associated with patient acceptance of noninvasive prenatal testing for trisomy 21, 18 and 13 via cell-free fetal DNA. METHODS: This was a retrospective study of all patients who were offered noninvasive prenatal testing at a single institution from 1 March 2012 to 2 July 2012. Patients were identified through our perinatal ultrasound database; demographic information, testing indication and insurance coverage were compared between patients who accepted the test and those who declined. Parametric and nonparametric tests were used as appropriate. Significant variables were assessed using multivariate logistic regression. The value p < 0.05 was considered significant. RESULTS: Two hundred thirty-five patients were offered noninvasive prenatal testing. Ninety-three patients (40%) accepted testing and 142 (60%) declined. Women who accepted noninvasive prenatal testing were more commonly white, had private insurance and had more than one testing indication. There was no statistical difference in the number or the type of testing indications. Multivariable logistic regression analysis was then used to assess individual variables. After controlling for race, patients with public insurance were 83% less likely to accept noninvasive prenatal testing than those with private insurance (3% vs. 97%, adjusted RR 0.17, 95% CI 0.05-0.62). CONCLUSION: In our population, having public insurance was the factor most strongly associated with declining noninvasive prenatal testing.
PMID: 23687914
ISSN: 1476-4954
CID: 2525292

First-trimester sonographic prediction of obstetric and neonatal outcomes in monochorionic diamniotic twin pregnancies

Allaf, M Baraa; Vintzileos, Anthony M; Chavez, Martin R; Wax, Joseph A; Ravangard, Samadh F; Figueroa, Reinaldo; Borgida, Adam; Shamshirsaz, Amir; Markenson, Glenn; Davis, Sarah; Habenicht, Rebecca; Haeri, Sina; Ozhand, Ali; Johnson, Jeffery; Sangi-Haghpeykar, Haleh; Spiel, Melissa; Ruano, Rodrigo; Meyer, Marjorie; Belfort, Michael A; Ogburn, Paul; Campbell, Winston A; Shamshirsaz, Alireza A
OBJECTIVES: The purpose of this study was to investigate whether discordant nuchal translucency and crown-rump length measurements in monochorionic diamniotic twins are predictive of adverse obstetric and neonatal outcomes. METHODS: We conducted a multicenter retrospective cohort study including all monochorionic diamniotic twin pregnancies with two live fetuses at the 11-week to 13-week 6-day sonographic examination who had serial follow-up sonography until delivery. Isolated nuchal translucency, crown-rump length, and combined discordances were correlated with adverse obstetric outcomes, individually and in composite, including the occurrence of 1 or more of the following in either fetus: intrauterine growth restriction (IUGR), twin-twin transfusion syndrome (TTTS), intrauterine fetal death (IUFD), growth discordance (>/= 20%), and preterm birth before 28 weeks' gestation. Correlations with adverse composite neonatal outcomes were also studied. A receiver operating characteristic curve analysis and a logistic regression analysis with a generalized estimating equation were conducted. RESULTS: Fifty-four of the 177 pregnancies included (31%) had an adverse composite obstetric outcome, with TTTS in 19 (11%), IUGR in 21 (12%), discordant growth in 14 (8%), IUFD in 14 (8%), and preterm birth before 28 weeks in 10 (6%). Of the 254 neonates included in the study, 69 (27%) were complicated by adverse composite neonatal outcomes, with respiratory distress syndrome being the most common (n = 59 [23%]). The areas under the curve for the combined discordances to predict composite obstetric and neonatal outcomes were 0.62 (95% confidence interval, 0.52-0.72), and 0.54 (95% confidence interval, 0.46-0.61), respectively. CONCLUSIONS: In our population, nuchal translucency, crown-rump length, and combined discordances in monochorionic diamniotic twin pregnancies were not predictive of adverse composite obstetric and neonatal outcomes.
PMID: 24371108
ISSN: 1550-9613
CID: 2525302

Revisiting ectopic pregnancy: a pictorial essay

Petrides, Artemis; Dinglas, Cheryl; Chavez, Martin; Taylor, Sharon; Mahboob, Sabrina
Ectopic pregnancies occur in approximately 1.4% of all pregnancies and account for 15% of pregnancy-related deaths. Considering the high degree of mortality, recognizing an ectopic pregnancy is important. Signs and symptoms of an ectopic pregnancy are nonspecific and include pain, vaginal bleeding, and an adnexal mass. Therefore, imaging can play a critical role in diagnosis. There are different types of ectopic pregnancies, which are tubal, cornual, cesarean scar, cervical, heterotopic, abdominal, and ovarian. Initial imaging evaluation of pregnant patients with pelvic symptoms is by ultrasonography, transabdominal, transvaginal or both. We review the sonographic appearance of different types of ectopic pregnancies that will aid in accurate and prompt diagnosis.
PMCID:4142466
PMID: 25161806
ISSN: 2156-7514
CID: 2525282

Timing of antenatal corticosteroid administration: are we giving it too early? [Meeting Abstract]

Adams, Tracy; Kinzler, Wendy; Matayeva, Elyana; Chavez, Martin; Vintzileos, Anthony
ISI:000313393500165
ISSN: 0002-9378
CID: 2800482

Neonatal Selective Head Cooling: Associated Placental Pathology. [Meeting Abstract]

Yeh, Corinne; Khullar, Poonam; Demishev, Michael; Saleh, Iman; Kinzler, Wendy; Chavez, Martin; Vintzileos, Anthony
ISI:000329543603052
ISSN: 1933-7191
CID: 3319582

Compliance with Postpartum Glucose Screening in Patients with Gestational Diabetes Mellitus. [Meeting Abstract]

Demishev, Michael; Martin, Terrissa; Kinzler, Wendy; Chavez, Martin; Vintzileos, Anthony
ISI:000329543603013
ISSN: 1933-7191
CID: 3319572

Maternal factors associated with neonatal selective head cooling [Meeting Abstract]

Saleh, Iman; Demishev, Michael; Yeh, Corinne; Chavez, Martin; Sicuranza, Genevieve; Kinzler, Wendy; Vintzileos, Anthony
ISI:000298889900122
ISSN: 0002-9378
CID: 3319552

Intra- and inter-observer variability in the evaluation of first trimester placental volume by 3D ultrasound [Meeting Abstract]

Muscat, Jolene; Chavez, Martin; Demishev, Michael; Allaf, Baraa; Ogburn, Paul; Vintzileos, Anthony
ISI:000298889900351
ISSN: 0002-9378
CID: 3319562

Does first-trimester ultrasound predict obstetrical outcomes in monochorionic diamniotic twin pregnancies? [Meeting Abstract]

Allaf, MBaraa; Ravangard, Samadh; Wax, Joseph; Chavez, Martin R; Borgida, Adam; Shamshirsaz, Amirhoushang A; Markenson, Glenn; Vintzileos, Anthony; Campbell, Winston; Egan, James; Figueroa, Reinaldo; Cartia, Angelina; Lee, Christopher; Shamshirsaz, Alireza A
ISI:000298889900359
ISSN: 0002-9378
CID: 2530252