bluuebunny/crossref_metadata_2025_split huggingface dataset:
Food and Drug Administration Warning on Anesthesia and Brain Development: Implications for Obstetric and Fetal Surgery
Authors: Olutoye O.A. , Baker B.W. , Belfort M.A. , Olutoye O.O. 
Published: November 2018

(Am J Obstet Gynecol. 2018;218(1):98–102)
The United States Food and Drug Administration has warned against the use of general anesthetics and sedation medications for >3 hours in pregnant women in the third trimester and children younger than 3 years old. The anesthetics agents listed included midazolam, propofol, and inhalational anesthetics (isoflurane, sevoflurane, and desflurane). They claim these agents may affect the development of children’s brains.
Diagnostic Accuracy of Ultrasound in Detecting the Severity of Abnormally Invasive Placentation: A Systematic Review and Meta-Analysis
Authors: Pagani G. , Cali G. , Acharya G. , Trisch I.T. , Palacios-Jaraquemada J. , Familiari A. , Buca D. , Manzoli L. , Flacco M.E. , Fanfani F. , Liberati M. , Scambia G. , D’antonio F. 
Published: November 2018

(Acta Obstet Gynecol Scand. 2018;97:25–37)
Abnormally invasive placentation (AIP) includes several conditions characterized by abnormal adherence and invasion of the placenta at its implantation site. Prenatal diagnosis of AIP and its preplanned management can reduce the maternal complications associated with this condition, including severe hemorrhage, the need for blood transfusion, and peripartum hysterectomy. The frequency and severity of complications from AIP is related to the degree of placental invasion. Prenatal ultrasound has been found to be relatively effective in detecting AIP, especially in those patients at increased risk, such as women with previous cesarean delivery and current placenta previa. However, its accuracy in detecting the severity of AIP is unclear. The purpose of this systematic review and meta-analysis was to elucidate the diagnostic accuracy of ultrasound in recognizing the severity of AIP.
Within Country Inequalities in Cesarean Section Rates: Observational Study of 72 Low and Middle Income Countries
Authors: Boatin A.A. , Schlotheuber A. , Betran A.P. , Moller A.B. , Barros A.J.D. , Boerma T. , Torloni M.R. , Victora C.G. , Hosseinpoor A.R. 
Published: November 2018

(BMJ. 2018;360:k55)
It remains unclear what the ideal cesarean section rate should be. Very low rates may be indicative of a lack of access when needed, leading to high rates of maternal and newborn morbidity and mortality. In contrast, high cesarean section rates suggest a bias for cesarean delivery without medical indication, increasing the risk of surgical complications, hemorrhage, and infection, Studies have shown that inequalities in cesarean section rates exist both between countries and within countries. The highest rates of cesarean delivery are generally observed among the wealthiest regions, and low rates are prevalent among the most disadvantaged areas. These inequalities have been shown to remain even as a country’s overall cesarean section rate has risen. The purpose of this observational study was to provide an update about economic inequalities in cesarean section rates within a large number of countries from various regions as well as the change in inequality over time.
Association Between Loss of Hospital-based Obstetric Services and Birth Outcomes in Rural Counties in the United States
Authors: Kozhimannil K.B. , Hung P. , Henning-Smith C. , Casey M.M. , Prasad S. 
Published: November 2018

(JAMA. 2018;319(12):1239–1247)
Between 2004 and 2014, hospital-based obstetric services have decreased from 55% to 46% in rural counties in the United States. Prior studies have shown that women and children in remote rural areas have delayed prenatal care initiation and higher rates of pregnancy hospitalizations, low birth weight, preterm births, and infant mortality. This retrospective cohort study examined whether the loss of rural obstetric services was associated with changes in location of childbirth or outcomes of care.
Anesthesia for Cesarean Delivery: A Cross-sectional Survey of Provincial, District, and Mission Hospitals in Zimbabwe
Authors: Lonnée H.A. , Madzimbamuto F. , Erlandsen O.R.M. , Vassenden A. , Chikumba E. , Dimba R. , Myhre A.K. , Ray S. 
Published: November 2018

(Anesth Analg. 2018;126:2056–2064)
In low- and middle-income countries like Zimbabwe, cesarean delivery (CD) is the most common surgical procedure, and as such, can indicate overall surgical activity in a health care system. Recent studies have shown the highest risk of anesthesia-related maternal death occurring in sub-Saharan Africa. Using a questionnaire, the authors of the present study assessed the type of anesthesia used for CD, level of training of anesthesia providers, and availability of resources in provincial, district, and mission hospitals in Zimbabwe.
Offspring Birthweight by Gestational Age and Parental Cardiovascular Mortality: A Population-based Cohort Study
Authors: Morken N.H. , Halland F. , DeRoo L.A. , Wilcox A.J. , Skjærvena R. 
Published: November 2018

(BJOG. 2018;125:336–341)
Worldwide, cardiovascular disease is the leading cause of death in women. Risk of cardiovascular disease may be identified by a woman’s physiological response to pregnancy. There is an established association between offspring low birthweight and parental cardiovascular disease and death. This study used linked data from 42 years of population-based registries to estimate the risk of parental cardiovascular disease mortality by offspring birthweight and gestational age.
Associations of Neighborhood-level Racial Residential Segregation With Adverse Pregnancy Outcomes
Authors: Salow A.D. , Pool L.R. , Grobman W.A. , Kershaw K.N. 
Published: November 2018

(Am J Obstet Gynecol. 2018;218:351.e1–351.e7)
Environmental factors, including racial residential segregation, may contribute to a higher risk of experiencing adverse pregnancy outcomes such as preterm birth (PTB). This study utilized electronic medical records to examine the associations of segregation among non-Hispanic Black women with overall PTB, spontaneous PTB, medically indicated PTB, and small-for-gestational-age birth.
Platelet Counts During Pregnancy
Authors: Reese J.A. , Peck J.D. , Deschamps D.R. , McIntosh J.J. , Knudtson E.J. , Terrell D.R. , Vesely S.K. , George J.N. 
Published: November 2018

(N Engl J Med. 2018;379:32–43)
In the present study, the authors evaluated platelet counts in women (15 to 44 y of age) who delivered at the Oklahoma University Medical Center between 2011 and 2014. Their objectives were to (1) evaluate the potential severity of gestational thrombocytopenia (<150,000 platelets/mm3 at the time of delivery) in uncomplicated pregnancies and risk for recurrence, (2) determine whether there was a relationship between identified pregnancy complications and platelet counts, and (3) ascertain associations between preexisting disorders and thrombocytopenia and any impact on pregnancy course.
Cost-effectiveness Analysis of Intraoperative Cell Salvage for Obstetric Hemorrhage
Authors: Lim G. , Melnyk V. , Facco F.L. , Waters J.H. , Smith K.J. 
Published: November 2018

(Anesthesiology. 2018;128(2):328–337)
Intraoperative cell salvage is recommended for blood conservation in cases of anticipated extreme blood loss, and reduces the need for allogeneic blood transfusion after cesarean delivery. There is a need for cost-effectiveness analysis of cell salvage in patients undergoing cesarean delivery to inform guidelines on obstetric blood management. Prior cost-effectiveness analysis demonstrated cost-savings in cases of massive transfusion or high risk of transfusion. This study aimed to use a societal perspective to analyze the cost-effectiveness of intraoperative cell salvage during cesarean delivery.
Atraumatic Versus Conventional Lumbar Puncture Needles: A Systematic Review and Meta-Analysis
Authors: Nath S. , Koziarz A. , Badhiwala J.H. , Alhazzani W. , Jaeschke R. , Sharma S. , Banfield L. , Shoamanesh A. , Singh S. , Nassiri F. , Oczkowski W. , Belley-Côté E. , Truant R. , Reddy K. , Meade M.O. , Farrokhyar F. , Bala M.M. , Alshamsi F. , Krag M. , Etxeandia-Ikobaltzeta I. , Kunz R. , Nishida O. , Matouk C. , Selim M. , Rhodes A. , Hawryluk G. , Almenawer S.A. 
Published: November 2018

(Lancet. 2018;391:1197–204)
Among patients who undergo lumbar puncture, up to 35% return to the hospital with a postdural puncture headache, which is caused by continuing leakage of the cerebrospinal fluid (CSF) from the dural defect created by the spinal needle. Conventional needles are most frequently used in clinical practice by nonanesthesiologists and have a sharp slanted tip designed to cut through the dura with a distal opening for injection of drugs or collection of CSF. As these needles cut through tissues, they cause irregular lacerations that can increase the potential for CSF leakage. In contrast, atraumatic needles are blunt with a closed pencil point tip and a side port for drug injection or CSF collection. They separate and dilate dural fibers rather than cutting through the fibers; thus they have been postulated to reduce the incidence of postdural puncture headache because they limit the leakage of CSF after lumbar puncture. Although atraumatic needles are now commonly used by anesthesiologists for spinal anesthesia, they are infrequently used by other clinicians as they seem unaware of their existence. This systematic review and meta-analysis of randomized controlled trials was performed to compare atraumatic and conventional lumbar puncture needles.
The Evolving Dilemma of Factor XI in Pregnancy: Suggestions for Management
Authors: Shander A. , Friedman T. , Palleschi G. , Shore-Lesserson L. 
Published: November 2018

(Anesth Analg. 2018;126:2032–2037)
Factor XI (FXI) deficiency or hemophilia C is an autosomal inherited multigenic bleeding disorder that can cause clinically significant hypocoagulability and bleeding, the severity of which does not correlate to the measured level of FXI. In this case study and discussion, the authors presented a 36-year-old pregnant patient of Ashkenazi Jewish descent with FXI deficiency, who had no history of excessive bleeding in multiple prior pregnancies. Before entering the authors’ practice, the patient had 4 previous uncomplicated vaginal deliveries, and denied any history of heavy menses or periods of heavy bleeding. In 2008 and 2012, the patient had 2 successful vaginal deliveries with no transfusions or noted postdelivery complications, with an estimated blood loss ranging from 250 to <300 mL. For her seventh pregnancy, a routine hematology evaluation advised that the patient “should be monitored. for excess bleeding peripartum.and given fresh frozen plasma (FFP) if needed.” Laboratory evaluation revealed an FXI level at 3% and an elevated activated partial thromboplastin time (aPTT) of 54.2 seconds. She prophylactically received 2 units of FFP, with a measured aPTT of 45 seconds after infusion, and the underwent a vaginal delivery of a healthy infant with an estimated blood loss of <250 mL. The patient was discharged from the hospital on postpartum day 1 with no complications.
Continuous Epidural Infusion Versus Programmed Intermittent Epidural Bolus for Labor Analgesia: A Prospective, Controlled, Before-and-After Cohort Study of Labor Outcomes
Authors: Bullingham A. , Liang S. , Edmonds E. , Mathur S. , Sharma S. 
Published: November 2018

(Br J Anaesth. 2018;121:432–437)
Recent studies have shown that programmed intermittent epidural bolus (PIEB) may be more effective at achieving lower rates of motor block, shortened second stage of labor, improved patient satisfaction outcomes, and lower total local anesthetic dose for labor pain than standard techniques like continuous epidural infusion (CEI) or patient-controlled epidural analgesia (PCEA). Therefore, the authors of this prospective, controlled, before-and-after cohort study evaluated the effectiveness of PIEB+PCEA versus CEI for labor analgesia in a tertiary referral hospital in Sydney, New South Wales, Australia.
Prophylactic Norepinephrine Infusion for Preventing Hypotension During Spinal Anesthesia for Cesarean Delivery
Authors: Ngan Kee W.D. , Lee S.W.Y. , Ng F.F. , Khaw K.S. 
Published: November 2018

(Anesth Analg. 2018;126:1989–1994)
Norepinephrine has been recently described as a possible alternative to phenylephrine for maintaining blood pressure during spinal anesthesia for cesarean delivery. However, its administration via manually titrated infusions in obstetric patients has not been previously described. The authors of the present study evaluated the efficacy of a titrated, manually controlled variable-rate infusion of norepinephrine for maintaining blood pressure and preventing hypotension in patients receiving spinal anesthesia for elective cesarean delivery.
Impact of Recommended Changes in Labor Management for Prevention of the Primary Cesarean Delivery
Authors: Thuillier C. , Roy S. , Peyronnet V. , Quibel T. , Nlandu A. , Rozenberg P. 
Published: November 2018

(Am J Obstet Gynecol. 2018;218(3):341.e1–341.e9)
The significant increase in cesarean delivery (CD) rates is a cause of concern due to the potential negative consequences for maternal and infant health. Indications for CD are often overused and the CD rates vary among institutions, according to the population, management, and local practices. Therefore, in 2014, the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM) jointly published an Obstetric Care Consensus for safe prevention of the primary CD. This consensus established new guidelines for management and definitions for arrest of labor (AoL) and failed induction. The objective of this study was to assess whether adoption of the new consensus recommendations contributed to a safe decrease in the primary CD rate.
Treatment Patterns and Clinical Outcomes in Neonates Diagnosed With Respiratory Distress Syndrome in a Low-income Country: A Report From Bangladesh
Authors: Hubbard R.M. , Choudhury K.M. , Lim G. 
Published: November 2018

(Anesth Analg. 2018;126:1684–1686)
Advances in neonatal critical care, such as surfactant replacement therapy (SRT), have led to significant reductions in neonatal mortality in the United States. However, respiratory distress syndrome (RDS)-related mortality rates remain high, particularly in areas with low resource availability, for example low-income countries. The authors of the present study described practice patterns and treatment modalities in RDS neonates in resource-limited settings and identified potential predictors of mortality.
Delineating the Association Between Mode of Delivery and Postpartum Depression Symptoms: A Longitudinal Study
Authors: Eckerdal P. , Georgakis M.K. , Kollia N. , Wikström A.K. , Högberg U. , Skalkidou A. 
Published: November 2018

(Acta Obstet Gynecol Scand. 2018;97:301–311)
Postpartum depression (PPD) affects around 10% to 20% of parturients. The main risk factors for PPD include presence of antepartum depression, history of psychiatric illness, low self-esteem, stressful life events, and the lack of social support. Research has also been performed investigating associations between factors such as mode of delivery, discrepancy between desired delivery mode and actual mode, and negative delivery experience and the development of PPD. Studies investigating mode of delivery and PPD have produced conflicting results. The aim of this longitudinal study was to unravel the association between mode of delivery and the risk of PPD, taking into account potential mediators and confounders, such as sociodemographic factors, psychiatric history, fear of delivery, delivery experience, and postpartum physical symptoms and complications.
Hydralazine Versus Nifedipine For Acute Hypertensive Emergency In Pregnancy: A Randomized Controlled Trial
Authors: Sharma C. , Soni A. , Gupta A. , Verma A. , Verma S. 
Published: November 2018

(Am J Obstet Gynecol. 2017;217:687.e1–687.e6)
Hypertensive disorders of pregnancy can contribute to maternal and fetal mortality and morbidity. Timely antihypertensive therapy is recommended to lower severe hypertension in preeclamptic women during pregnancy. Intravenous hydralazine, intravenous labetalol, and oral nifedipine are commonly used to control the blood pressure (BP) in such women, but there is a paucity of evidence regarding the best option for the acute control of BP in the setting of severe sustained hypertension. This double-blind, randomized, controlled trial was conducted to determine the efficacy of 2 commonly used agents—intravenous hydralazine and oral nifedipine—for controlling acute severe hypertension in pregnant women with preeclampsia.
III. REGIONAL ANESTHESIA Using Activity Trackers to Quantify Postpartum Ambulation: A Prospective Observational Study of Ambulation After Regional Anesthesia and Analgesia Interventions
Authors: Ma J. , Martin R. , Chan B. , Gofeld M. , Geary M.P. , Laffey J.G. , Abdallah F.W. 
Published: November 2018

(Anesthesiology. 2018;128:598–608)
Early ambulation can improve outcomes in surgical patients and is an important component of enhanced recovery. However, there is a lack of evidence on the ideal approach for evaluating early ambulation. Real-time quantification of ambulation is important, as most tools used to collect activity information are influenced by recall bias. This prospective observational study explored the feasibility of the use of activity fitness trackers in objectively quantifying ambulation, hypothesizing that in the 24 hours after delivery, vaginal delivery patients would have greater ambulation than cesarean delivery patients.
Clonidine Effect on Pain After Cesarean Delivery: A Randomized Controlled Trial of Different Routes of Administration
Authors: Fernandes H.S. , Bliacheriene F. , Vago T.M. , Corregliano G.T. , Torres M.L. , Francisco R.P. , Ashmawi H.A. 
Published: November 2018

(Anesth Analg. 2018;127:165–170)
Systemic clonidine [oral or intravenous (IV)] has been administered preoperatively for attenuation of perioperative hemodynamic instability and for reducing anesthetic and postoperative analgesic needs. However, IV clonidine has not been evaluated as an adjuvant during cesarean delivery. In the present study, the authors evaluated and compared the effectiveness of standard spinal anesthesia, standard spinal anesthesia combined with intrathecal clonidine, and standard spinal anesthesia combined with IV clonidine.
Trends in Self-reported and Biochemically Tested Marijuana Use Among Pregnant Females in California From 2009 to 2016
Authors: Young-Wolff K.C. , Tucker L.Y. , Alexeeff S. , Armstrong M.A. , Conway A. , Weisner C. , Goler N. 
Published: November 2018

(JAMA. 2017;318(24):2490–2491)
Self-reported marijuana use in adult pregnant women in the United States increased from 2.4% to 3.9% between 2002 and 2014. The scope of marijuana use in pregnant women is left unclear due to social bias in self-reporting and underreporting. This study used data from the years 2009-2016 from a large California health care system using self-reporting and urine toxicology screening.
Technique for partial transphyseal anterior cruciate ligament reconstruction in skeletally immature athletes: preliminary results
Authors: Bettin Clayton C. , Throckmorton Thomas W. , Miller Robert H. , Azar Frederick M. 
Published: November 2018

Background:
A number of safe and successful surgical techniques to avoid physeal injury about the knee have been described, but their reported outcomes have not equaled success rates of procedures in skeletally mature patients. The purpose of this study was to determine the outcomes of an arthroscopic-assisted ACL reconstruction using a quadruple-looped hamstring graft with a synthetic graft extender and a physeal-sparing technique for partial transphyseal ACL reconstruction in skeletally immature patients.

Methods:
Medical record review identified skeletally immature patients who had this procedure and a minimum 6-month follow-up. A quadrupled-looped hamstring autograft and a synthetic graft extender allowed the optimal portion of the graft to be placed intra-articular and maintain sufficient length for proximal and distal fixation. Repeat physical examination included KT-1000 measurement, scanogram, and completion of a Lysholm knee scale and International Knee Documentation Committee (IKDC) evaluation.

Results:
Seventeen male patients 7.7 to 14.9 yr who fit the inclusion criteria were identified. All had open tibial and femoral physes at the time of ACL reconstruction. Average follow-up was 2 yr. At latest follow-up, all patients had stable Lachman tests and were able to return to sporting activities at their previous levels. Average limb-length discrepancy was 2.2 mm, with an average angular difference of 1.7 degrees, neither of which was statistically or clinically significant. Average Lysholm score was 91.5, and the average IKDC score was 92.7.

Conclusions:
This technique can restore motion and stability after ACL injury in skeletally immature patients while minimizing the risk of growth disturbance that might result in length or angular deformities.

Level of Evidence:
IV.
Retrograde Stainless Steel Flexible Nails Have Superior Resistance to Bending in Distal Third Femoral Shaft Fractures
Authors: Hubbard Elizabeth W. , Thompson Rachel M. , Jo Chan-Hee , Pierce William A. , Riccio Anthony I. , Wimberly Robert L. 
Published: November 2018

Background:
It has been shown that retrograde titanium flexible intramedullary nails (Ti FIN) provide superior resistance to bending compared to antegrade Ti FIN in distal femur fractures. The purpose of this study was to compare resistance to torsional and bending forces of stainless steel (SS) FIN, with or without a locking screw, and Ti FIN in distal third femoral shaft fractures. We hypothesize that locked retrograde SS FIN will demonstrate greater resistance to both bending and torsional forces.

Methods:
Thirty adolescent synthetic femur models were used to simulate transverse distal femoral fractures at either 60 mm or 90 mm proximal to the distal femoral physis. The femurs were instrumented with antegrade Ti FIN, antegrade SS FIN, retrograde Ti FIN, retrograde SS FIN, or retrograde locked SS FIN. Three models for each construct at both osteotomy levels were tested. Models were analyzed to determine maximum resistance to bending and torsion.

Results:
In fractures 60 mm from the physis, retrograde SS FIN demonstrated statistically superior resistance to bending when compared with both antegrade and retrograde Ti FIN (P=0.001 and 0.008, respectively) and antegrade SS FIN (P=0.0001). Locked SS constructs showed a trend towards greater resistance to bending forces when compared with unlocked constructs (P>0.05). No significant difference was seen in resistance to bending when fractures were 90 mm proximal to the distal femoral physis between the five groups. No significant differences were observed in resistance to torsion in either the proximal or distal fracture models, regardless of construct type.

Conclusions:
Retrograde SS FIN confer significantly greater resistance to bending forces for fractures 60 mm proximal to the distal femoral physis compared with Ti FIN or antegrade entry SS FIN. In fractures 90 mm from the physis, no differences were noted in our model. Our results support the use of retrograde SS nails in the pediatric patient with distal femoral shaft fractures.

Level of Evidence:
Level II—comparative biomechanical study.