The Association Between Intended Mode of Delivery and Maternal Morbidity in Twin Pregnancies
We have published several studies demonstrating that planned vaginal delivery of twins is associated with similar neonatal outcomes as compared to planned cesarean delivery (https://www.carnegieimaging.com/blog/ci-publications/long-term-outcomes-twins-based-intended-mode-delivery/) and (https://www.carnegieimaging.com/blog/ci-publications/active-second-stage-management-in-twin-pregnancies-undergoing-planned-vaginal-delivery-in-a-u-s-population/). In this study, we demonstrate that maternal outcomes are similar or better with planned vaginal delivery, as compared to planned cesarean delivery. This gives further support to women with twin pregnancies attempting a vaginal delivery, if clinically appropriate.
Risk Factors for Positive Postpartum Depression Screen in Women With Private Health Insurance and Access to Care
Postpartum depression is a common and potentially devastating condition for a new mother. There are many known risk factors for postpartum depression, but many of them are related to poor access to health care . In this study, we sought to find risk factors for postpartum depression amongst a large cohort of women with private health insurance and excellent access to care.
Minimally Invasive Treatment of Cesarean Scar and Cervical Pregnancies Using a Cervical Ripening Double Balloon Catheter
Cesarean scar ectopic is a life-threatening condition in early pregnancy with an increasing prevalence. We originally described a novel, outpatient, minimally-invasive approach to this potentially devastating condition. As a follow-up to our original study ng this approach, we published an expanded case series describing excellent outcomes in 38 women treated by several medical centers.
Time to Delivery After Scheduled Shirodkar Cerclage Removal in Singleton Gestations Based on the Original Indication for Cerclage Placement
The best timing of cerclage removal is unknown. In this study, we examined time of cerclage removal to delivery to try to help establish the ideal gestational age window to schedule cerclage removal.
Glycemic Control in Twin Pregnances With Gestational Diabetes: Are We Improving or Worsening Outcomes?
Twin pregnancies are at increased risk of gestational diabetes. However, although diagnosis and treatment of gestational diabetes has been shown to be useful in singleton pregnancies, it is unclear if this is true in twin pregnancies as well. For example, one of the risks of gestational diabetes is fetal macrosomia, or a very large fetus, which is extremely uncommon in twin pregnancies, even those with gestational diabetes. In this study we found that stricter control of gestational diabetes in twin pregnancies was actually associated with worse outcomes. We suggest that more research needs to be done to determine the optimal treatment of gestational diabetes in twin pregnancies.
Accuracy of Sonographic Estimated Fetal Weight in Suspected Macrosomia: The Likelihood of Overestimating and Underestimating in True Birthweight
Prior to delivery, the fetal weight is often estimated either by feeling the maternal abdomen or by ultrasound. There are many studies describing the accuracy of these methods. In this study, we took a unique look at this issue and calculated the likelihood an ultrasound showing a large fetal weight was over- or under-estimating the true weight. As the estimated weight got larger, the chance ultrasound over-estimates also increases. This can be useful clinically when receiving an ultrasound report of a large fetal weight.
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