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  1. Article ; Online: Neonatal brachial plexus palsy: incidence, prevalence, and temporal trends.

    Chauhan, Suneet P / Blackwell, Sean B / Ananth, Cande V

    Seminars in perinatology

    2014  Volume 38, Issue 4, Page(s) 210–218

    Abstract: Epidemiological knowledge of the incidence, prevalence, and temporal changes of neonatal brachial plexuses palsy (NBPP) should assist the clinician, avert unnecessary interventions, and help formulate evidence-based health policies. A summary of 63 ... ...

    Abstract Epidemiological knowledge of the incidence, prevalence, and temporal changes of neonatal brachial plexuses palsy (NBPP) should assist the clinician, avert unnecessary interventions, and help formulate evidence-based health policies. A summary of 63 publications in the English language with over 17 million births and 24,000 NBPPs is notable for six things. First, the rate of NBPP in the US and other countries is comparable: 1.5 vs. 1.3 per 1000 total births, respectively. Second, the rate of NBPP may be decreasing: 0.9, 1.0 and 0.5 per 1,000 births for publications before 1990, 1990-2000, and after 2000, respectively. Third, the likelihood of not having concomitant shoulder dystocia with NBPP was 76% overall, though it varied by whether the publication was from the US (78%) vs. other countries (47%). Fourth, the likelihood of NBPP being permanent (lasting at least 12 months) was 10-18% in the US-based reports and 19-23% in other countries. Fifth, in studies from the US, the rate of permanent NBPP is 1.1-2.2 per 10,000 births and 2.9-3.7 per 10,000 births in other nations. Sixth, we estimate that approximately 5000 NBPPs occur every year in the US, of which over 580-1050 are permanent, and that since birth, 63,000 adults have been afflicted with persistent paresis of their brachial plexus. The exceedingly infrequent nature of permanent NBPP necessitates a multi-center study to improve our understanding of the antecedent factors and to abate the long-term sequela.
    MeSH term(s) Brachial Plexus Neuropathies/epidemiology ; Brachial Plexus Neuropathies/prevention & control ; Brain Diseases/epidemiology ; Brain Diseases/prevention & control ; Cesarean Section/statistics & numerical data ; Delivery, Obstetric/methods ; Dystocia/epidemiology ; Female ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Male ; Perinatal Death/prevention & control ; Pregnancy ; Prevalence ; Risk Factors ; Shoulder ; Time Factors ; United States/epidemiology
    Language English
    Publishing date 2014-06
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 752403-1
    ISSN 1558-075X ; 0146-0005
    ISSN (online) 1558-075X
    ISSN 0146-0005
    DOI 10.1053/j.semperi.2014.04.007
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Care Levels for Fetal Therapy Centers.

    Baschat, Ahmet A / Blackwell, Sean B / Chatterjee, Debnath / Cummings, James J / Emery, Stephen P / Hirose, Shinjiro / Hollier, Lisa M / Johnson, Anthony / Kilpatrick, Sarah J / Luks, Francois I / Menard, M Kathryn / McCullough, Lawrence B / Moldenhauer, Julie S / Moon-Grady, Anita J / Mychaliska, George B / Narvey, Michael / Norton, Mary E / Rollins, Mark D / Skarsgard, Eric D /
    Tsao, KuoJen / Warner, Barbara B / Wilpers, Abigail / Ryan, Greg

    Obstetrics and gynecology

    2022  Volume 139, Issue 6, Page(s) 1027–1042

    Abstract: Fetal therapies undertaken to improve fetal outcome or to optimize transition to neonate life often entail some level of maternal, fetal, or neonatal risk. A fetal therapy center needs access to resources to carry out such therapies and to manage ... ...

    Abstract Fetal therapies undertaken to improve fetal outcome or to optimize transition to neonate life often entail some level of maternal, fetal, or neonatal risk. A fetal therapy center needs access to resources to carry out such therapies and to manage maternal, fetal, and neonatal complications that might arise, either related to the therapy per se or as part of the underlying fetal or maternal condition. Accordingly, a fetal therapy center requires a dedicated operational infrastructure and necessary resources to allow for appropriate oversight and monitoring of clinical performance and to facilitate multidisciplinary collaboration between the relevant specialties. Three care levels for fetal therapy centers are proposed to match the anticipated care complexity, with appropriate resources to achieve an optimal outcome at an institutional and regional level. A level I fetal therapy center should be capable of offering fetal interventions that may be associated with obstetric risks of preterm birth or membrane rupture but that would be very unlikely to require maternal medical subspecialty or intensive care, with neonatal risks not exceeding those of moderate prematurity. A level II center should have the incremental capacity to provide maternal intensive care and to manage extreme neonatal prematurity. A level III therapy center should offer the full range of fetal interventions (including open fetal surgery) and be able manage any of the associated maternal complications and comorbidities, as well as have access to neonatal and pediatric surgical intervention including indicated surgery for neonates with congenital anomalies.
    MeSH term(s) Child ; Female ; Fetal Membranes, Premature Rupture ; Fetal Therapies ; Humans ; Infant, Newborn ; Infant, Premature ; Pregnancy ; Premature Birth ; Prenatal Care
    Language English
    Publishing date 2022-05-02
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 207330-4
    ISSN 1873-233X ; 0029-7844
    ISSN (online) 1873-233X
    ISSN 0029-7844
    DOI 10.1097/AOG.0000000000004793
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Obstetric Recommendations in American Congress of Obstetricians and Gynecologists Practice Bulletins versus UpToDate: a comparison.

    Myer, Emily N B / Too, Gloria T / Hammad, Ibrahim A / Babbar, Shilpa / Martin, Charley E / Hill, James B / Blackwell, Sean B / Chauhan, Suneet P

    American journal of perinatology

    2015  Volume 32, Issue 5, Page(s) 427–444

    Abstract: Objective: To compare the obstetric recommendations in American Congress of Obstetricians and Gynecologists (ACOG) practice bulletins (PB) with similar topics in UpToDate (UTD).: Study design: We accessed all obstetric PB and cross-searched UTD (May ... ...

    Abstract Objective: To compare the obstetric recommendations in American Congress of Obstetricians and Gynecologists (ACOG) practice bulletins (PB) with similar topics in UpToDate (UTD).
    Study design: We accessed all obstetric PB and cross-searched UTD (May 1999-May 2013). We analyzed only the PB which had corresponding UTD chapter with graded recommendations (level A-C). To assess comparability of recommendations for each obstetric topic, two maternal-fetal medicine (MFM) subspecialists categorized the statement as similar, dissimilar, or incomparable. Simple and weighted kappa statistics were calculated to assess agreement between the two raters.
    Results: We identified 46 ACOG obstetric PB and 86 UTD chapters. There were 50% fewer recommendations in UTD than in PB (181 vs. 365). The recommendations being categorized as level A, B, or C was significantly different (p < 0.001) for the two guidelines. While the overall concordance rate between the two MFM subspecialists was 83% regarding the recommendations for the same topic as similar, dissimilar, or incomparable, the agreement was moderate (kappa, 0.56; 95% confidence intervals, 0.48-0.65).
    Conclusion: Though obstetricians have two sources for graded recommendations, incongruity among them may be a source of consternation. Congruent recommendations from ACOG and UTD could enhance compliance and potentially optimize outcomes.
    MeSH term(s) Female ; Humans ; Obstetrics/standards ; Practice Guidelines as Topic ; Pregnancy ; Research Design ; Societies, Medical ; United States
    Language English
    Publishing date 2015-04
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Review
    ZDB-ID 605671-4
    ISSN 1098-8785 ; 0735-1631
    ISSN (online) 1098-8785
    ISSN 0735-1631
    DOI 10.1055/s-0034-1396684
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Obstetric Recommendations in American Congress of Obstetricians and Gynecologists Practice Bulletins versus UpToDate: A Comparison

    Myer, Emily N. B. / Too, Gloria T. / Hammad, Ibrahim A. / Babbar, Shilpa / Martin, Charley E. / Hill, James B. / Blackwell, Sean B. / Chauhan, Suneet P.

    American Journal of Perinatology

    2014  Volume 32, Issue 05, Page(s) 427–444

    Abstract: Objective: To compare the obstetric recommendations in American Congress of Obstetricians and Gynecologists (ACOG) practice bulletins (PB) with similar topics in UpToDate (UTD).: Study Design: We accessed all obstetric PB and cross-searched UTD (May ... ...

    Abstract Objective: To compare the obstetric recommendations in American Congress of Obstetricians and Gynecologists (ACOG) practice bulletins (PB) with similar topics in UpToDate (UTD).
    Study Design: We accessed all obstetric PB and cross-searched UTD (May 1999–May 2013). We analyzed only the PB which had corresponding UTD chapter with graded recommendations (level A–C). To assess comparability of recommendations for each obstetric topic, two maternal–fetal medicine (MFM) subspecialists categorized the statement as similar, dissimilar, or incomparable. Simple and weighted kappa statistics were calculated to assess agreement between the two raters.
    Results: We identified 46 ACOG obstetric PB and 86 UTD chapters. There were 50% fewer recommendations in UTD than in PB (181 vs. 365). The recommendations being categorized as level A, B, or C was significantly different ( p  < 0.001) for the two guidelines. While the overall concordance rate between the two MFM subspecialists was 83% regarding the recommendations for the same topic as similar, dissimilar, or incomparable, the agreement was moderate (kappa, 0.56; 95% confidence intervals, 0.48–0.65).
    Conclusion: Though obstetricians have two sources for graded recommendations, incongruity among them may be a source of consternation. Congruent recommendations from ACOG and UTD could enhance compliance and potentially optimize outcomes.
    Keywords practice bulletins ; UpToDate ; obstetric recommendations ; ACOG
    Language English
    Publishing date 2014-12-29
    Publisher Thieme Medical Publishers
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 605671-4
    ISSN 1098-8785 ; 0735-1631
    ISSN (online) 1098-8785
    ISSN 0735-1631
    DOI 10.1055/s-0034-1396684
    Database Thieme publisher's database

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