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353. Operative vaginal delivery 10 components of success: the need for forceps or vacuum should not be determined on the fly, but anticipated and evaluated, with a willing patient

Author

Belfort, Michael A.

Subjects
Natural childbirth -- Risk factors -- Analysis -- Health aspects, Informed consent (Medical law) -- Analysis -- Health aspects, Pregnant women -- Health aspects -- Analysis
Abstract

Operative vaginal delivery is a dying art. National databases in the United States and elsewhere have shown this trend for decades. (1) Women no longer can be reliably predicted to […]

Published
2007

356. Navigating a thyroid storm

Author

Belfort, Michael A.

Subjects
Pregnant women -- Health aspects, Pregnant women -- Care and treatment, Hyperthyroidism -- Care and treatment, Hyperthyroidism -- Diagnosis, Hyperthyroidism -- Development and progression, Infants -- Patient outcomes, Infants -- Prevention, Health
Published
2006

357. Defining definitions: a Delphi study to develop a core outcome set for conditions of severe maternal morbidity

Author

Schaap, T, Bloemenkamp, K, Deneux-Tharaux, Cairns, Knight, Megan, Langhoff-Roos, J., Sullivan, Elizabeth, van den Akker, T, Rigouzzo, Agnes, Univ, Comenius, Creanga, Andreea, Koopman, Ankie, Franx, Arie, Nemethova, Bianka, Bateman, Brian, Daelemans, Caroline, Zelop, Carolyn, Medicine, Boston University School, Nagata, Chie, Farquhar, Cindy M., Huisman, Claartje, von Kaisenberg, Constantin, Henruquez, Dacia, Ellwood, David, Moolenaar, David, Kuklina, Elena, Main, Elliott, Stekkinger, Eva, Gollo, Evelina, Goffinet, Francois, Kainer, Franz, Africa, University of Pretoria Kalafong Academic Hospital, Stralen, Giel, Kayem, Gilles, Duvekot, Hans, Franz, Heiko B G, Engjom, Hilde, Beenakkers, Ingrid, Al-Zirqi, Iqbal, Danis, Jakub, Berlac, Foss, UK, Leicester Royal, Parsonage, Will, Zwart, Joost, van Roosmalen, Jos, Klungsor, Kari, Lust, Karin, Vetter, Klaus, Calsteren, Kristel, Roelens, Kristien, Krebs, Lone, Colmorn, Berdiin, Tanaka, Mamoru, Rijken, Marcus, Bonnet, Marie-Pierre, Boer, Marjon, Jokinen, Mervi, Belfort, Michael, Peek, Michael, Gisler, Mika, Foley, Mike, Tikkanen, Minna, Korbel, Miroslav, laubach, Monika, Schuitemaker, Nico, Engel, Nicole, McDonnell, Nolan, Emonts, Patrick, Rozenberg, Patrick, Hillemanns, Peter, Rauskolb, Rudiger, Takeda, Satoru, Donati, Serena, Ferrazzani, Sergio, Saito, Shigeru, Jesudason, Shilpanjali, Satoh, Shoji, Health, Norwegian Institute of, Clark, Steven, Koenen, Steven, Grussner, Susanne, Miyashita, Susumu, Fischer, Thorsten, Todros, Tullia, Mijatovic, Veljia, Basevi, Vittorio, Pollock, Wendy, Callaghan, William, Henrich, Wolfgang, Fujita, Yasuyuki, Matsuda, Yoshio, Garnier, Yves, Zentner, Dominica, other, and, Schaap, T, Bloemenkamp, K, Deneux-Tharaux, Cairns, Knight, Megan, Langhoff-Roos, J., Sullivan, Elizabeth, van den Akker, T, Rigouzzo, Agnes, Univ, Comenius, Creanga, Andreea, Koopman, Ankie, Franx, Arie, Nemethova, Bianka, Bateman, Brian, Daelemans, Caroline, Zelop, Carolyn, Medicine, Boston University School, Nagata, Chie, Farquhar, Cindy M., Huisman, Claartje, von Kaisenberg, Constantin, Henruquez, Dacia, Ellwood, David, Moolenaar, David, Kuklina, Elena, Main, Elliott, Stekkinger, Eva, Gollo, Evelina, Goffinet, Francois, Kainer, Franz, Africa, University of Pretoria Kalafong Academic Hospital, Stralen, Giel, Kayem, Gilles, Duvekot, Hans, Franz, Heiko B G, Engjom, Hilde, Beenakkers, Ingrid, Al-Zirqi, Iqbal, Danis, Jakub, Berlac, Foss, UK, Leicester Royal, Parsonage, Will, Zwart, Joost, van Roosmalen, Jos, Klungsor, Kari, Lust, Karin, Vetter, Klaus, Calsteren, Kristel, Roelens, Kristien, Krebs, Lone, Colmorn, Berdiin, Tanaka, Mamoru, Rijken, Marcus, Bonnet, Marie-Pierre, Boer, Marjon, Jokinen, Mervi, Belfort, Michael, Peek, Michael, Gisler, Mika, Foley, Mike, Tikkanen, Minna, Korbel, Miroslav, laubach, Monika, Schuitemaker, Nico, Engel, Nicole, McDonnell, Nolan, Emonts, Patrick, Rozenberg, Patrick, Hillemanns, Peter, Rauskolb, Rudiger, Takeda, Satoru, Donati, Serena, Ferrazzani, Sergio, Saito, Shigeru, Jesudason, Shilpanjali, Satoh, Shoji, Health, Norwegian Institute of, Clark, Steven, Koenen, Steven, Grussner, Susanne, Miyashita, Susumu, Fischer, Thorsten, Todros, Tullia, Mijatovic, Veljia, Basevi, Vittorio, Pollock, Wendy, Callaghan, William, Henrich, Wolfgang, Fujita, Yasuyuki, Matsuda, Yoshio, Garnier, Yves, Zentner, Dominica, and other, and

Abstract

Objective: Develop a core outcome set of international consensus definitions for severe maternal morbidities. Design: Electronic Delphi study. Setting: International. Population: Eight expert panels. Methods: All 13 high-income countries represented in the International Network of Obstetric Surveillance Systems (INOSS) nominated five experts per condition of morbidity, who submitted possible definitions. From these suggestions, a steering committee distilled critical components: eclampsia: 23, amniotic fluid embolism: 15, pregnancy-related hysterectomy: 11, severe primary postpartum haemorrhage: 19, uterine rupture: 20, abnormally invasive placentation: 12, spontaneous haemoperitoneum in pregnancy: 16, and cardiac arrest in pregnancy: 10. These components were assessed by the expert panel using a 5-point Likert scale, following which a framework for an encompassing definition was constructed. Possible definitions were evaluated in rounds until a rate of agreement of more than 70% was reached. Expert commentaries were used in each round to improve definitions. Main outcome measures: Definitions with a rate of agreement of more than 70%. Results: The invitation to participate in one or more of eight Delphi processes was accepted by 103 experts from 13 high-income countries. Consensus definitions were developed for all of the conditions. Conclusion: Consensus definitions for eight morbidity conditions were successfully developed using the Delphi process. These should be used in national registrations and international studies, and should be taken up by the Core Outcomes in Women's and Newborn Health initiative. Tweetable abstract: Consensus definitions for eight morbidity conditions were successfully developed using the Delphi process.

Published
2019

358. Qualitative assessment of knowledge transfer regarding preterm birth in Malawi following the implementation of targeted health messages over 3 years

Author

Antony,Kathleen M, Levison,Judy, Suter,Melissa A, Raine,Susan, Chiudzu,Grace, Phiri,Henry, Sclafani,Joseph, Belfort,Michael, Kazembe,Peter, Aagaard,Kjersti M, Antony,Kathleen M, Levison,Judy, Suter,Melissa A, Raine,Susan, Chiudzu,Grace, Phiri,Henry, Sclafani,Joseph, Belfort,Michael, Kazembe,Peter, and Aagaard,Kjersti M

Abstract

Kathleen M Antony,1,2 Judy Levison,1 Melissa A Suter,1 Susan Raine,1 Grace Chiudzu,3 Henry Phiri,3 Joseph Sclafani,1,3,4 Michael Belfort,1 Peter Kazembe,4 Kjersti M Aagaard1 1Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA; 2Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Wisconsin-Madison, Madison, WI, USA; 3Department of Obstetrics and Gynecology, Kamuzu Central Hospital, Lilongwe, Malawi; 4Baylor College of Medicine Children’s Clinical Center of Excellence, Kamuzu Central Hospital, Lilongwe, Malawi Background: In 2012, we performed a needs assessment and gap analysis to qualitatively assess providers’ and patients’ knowledge and perceptions regarding preterm birth (PTB). During the study, we identified knowledge gaps surrounding methods to reduce the risk of occurrence of PTB and management options if preterm labor/birth occur. We targeted health messages toward these gaps. The objective of the present study was to assess the impact of our community health worker-based patient education program 3 years after it was implemented.Methods: Fifteen focus groups including 70 participants were included in the study. The groups comprised either patients/patient couples or health providers. A minimum of two facilitators led each group using 22 a priori designed and standardized lead-in prompts for participants with four additional prompts for providers only. A single researcher recorded responses, and transcript notes were reviewed by the facilitators and interpreters immediately following each group discussion to ensure accuracy.Results: The understanding of term vs preterm gestation was generally accurate. Every participant knew of women who had experienced PTB, and the general perception was that two to three women out of every ten had this experience. The majority of respondents thought that women should present to their local health clinic if they experienc

Published
2019

368. Effects of delayed versus immediate umbilical cord clamping in reducing death or major disability at 2 years corrected age among very preterm infants (APTS): a multicentre, randomised clinical trial

Author

Robledo, Kristy P, Tarnow-Mordi, William O, Rieger, Ingrid, Suresh, Preeti, Martin, Andrew, Yeung, Carbo, Ghadge, Alpana, Liley, Helen G, Osborn, David, Morris, Jonathan, Hague, Wendy, Kluckow, Martin, Lui, Kei, Soll, Roger, Cruz, Melinda, Keech, Anthony, Kirby, Adrienne, Simes, John, Popat, Himanshu, Reid, Shelley, Gordon, Adrienne, De Waal, Koert, Wright, Ian M, Wright, Anne, Buchan, Jane, Stubbs, Michelle, Newnham, John, Simmer, Karen, Young, Cherry, Loh, Diane, Kok, Yen, Gill, Andy, Strunk, Tobias, Jeffery, Michele, Chen, Yan, Morris, Scott, Sinhal, Sanjay, Cornthwaite, Kathryn, Walker, Sue P, Watkins, Andrew M, Collins, Clare L, Holberton, James R, Noble, Elizabeth J, Sehgal, Arvind, Yeomans, Emma, Elsayed, Kristy, Mohamed, Abdel-Latif, Broom, Margaret, Koh, Guan, Lawrence, Annemarie, Gardener, Glen, Fox, Jane, Cartwright, David W, Koorts, Pieter, Pritchard, Margo A, McKeown, Lisa, Lainchbury, Anne, Shand, Antonia W, Michalowski, Joanna, Smyth, John P, Bolisetty, Srinivas, Adno, Alan, Lee, Gaksoo, Seidler, Anna L, Askie, Lisa M, Groom, Katie M, Eaglen, Deborah A, Baker, Ella C, Patel, Harshad, Wilkes, Natalie, Gullam, Joanna E, Austin, Nicola, Leishman, Dianne E, Weston, Phil, White, Nicola, Cooper, Nadia A, Broadbent, Roland, Stitely, Michael, Dawson, Pauline, El-Naggar, Walid, Furlong, Marlene, Hatfield, Tara, de Luca, Daniele, Benachi, Alexandra, Letamendia-Richard, Emmanuelle, Escourrou, Guillaume, Dell'Orto, Valentina, Sweet, David, Millar, Muriel, Shah, Shilpa, Sheikh, Lumaan, Ariff, Shabina, Morris, Erin A, Young, Leslie, Evans, Shannon K, Belfort, Michael, Aagaard, Kjersti, Pammi, Mohan, Mandy, George, Gandhi, Manisha, Davey, Jane, Shenton, Emma, Middleton, Jennifer, Black, Roslyn, Cheng, Annie, Murdoch, Jamie, Jacobs, Claire, Meyer, Lizzie, Medlin, Kathryn, Woods, Heather, O'Connor, Kerry-Ann, Bice, Caitlin, Scott, Katherine, Hayes, Marie, Cruickshank, Debbie, Sam, Mekha, Ireland, Susan, Dickinson, Corrine, Poulsen, Leith, Fucek, Andreja, Hegarty, Jo, Rogers, Jenny, Sanchez, Dorothy, Zupan Simunek, Veronique, Hanif, Bakhtawar, Pahl, Adrienne, Metayer, Jerilyn, Duley, Lelia, Marlow, Neil, Schofield, Deborah, and Bowen, Jennifer

Abstract

Very preterm infants are at increased risk of adverse outcomes in early childhood. We assessed whether delayed clamping of the umbilical cord reduces mortality or major disability at 2 years in the APTS Childhood Follow Up Study.

Published
2022
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369. Transcranial Doppler measurement of cerebral velocity indices as a predictor of preeclampsia

Author

Rishkin-Mashiah, Shlomit, Belfort, Michael A., Saade, George R., and Herd, J. Alan

Subjects
Preeclampsia -- Physiological aspects, Cerebral circulation -- Abnormalities, Health
Abstract

Preeclampsia may be caused partly by changes in blood flow in the blood vessels in the brain, according to a study of 166 pregnant women. These changes may occur before the woman develops preeclampsia. If so, this could be used to identify these women before they develop symptoms, since blood flow can be measured during an ultrasound scan.

Published
2002

375. Inhibition of cyclooxygenase but not nitric oxide synthase influences effects on the human omental artery of the thromboxane A(sub 2) mimetic U46619 and 17beta-estradiol

Author

Vedernikov, Yuri P., Belfort, Michael A., Saade, George R., and Garfield, Robert E.

Subjects
Estradiol -- Physiological aspects, Blood vessels -- Dilatation, Health
Abstract

Blood vessel relaxation caused by estrogen does not involve nitric oxide production. Instead, it appears to involve the production of substances that inhibit contraction.

Published
2001

377. Accuracy of Ultrasound to Predict Neonatal Birth Weight Among Fetuses With Gastroschisis: Impact on Timing of Delivery.

Author

Fisher, James E., Tolcher, Mary C., Shamshirsaz, Alireza A., Espinoza, Jimmy, Sanz Cortes, Magdalena, Donepudi, Roopali, Belfort, Michael A., and Nassr, Ahmed A.

Subjects
ULTRASONIC imaging, SMALL for gestational age, BIRTH weight, FETAL growth retardation, GASTROSCHISIS
Abstract

Objectives: To determine the accuracy of ultrasound estimation of fetal weight among fetuses with gastroschisis and how the diagnosis of fetal growth restriction (FGR) affects the timing of delivery. Methods: This was a retrospective cohort study including all fetuses with a diagnosis of gastroschisis at our institution from November 2012 through October 2017. We excluded multiple gestations, pregnancies with major structural or chromosomal abnormalities, and those for which prenatal and postnatal follow‐up were unavailable. Performance characteristics of ultrasound to predict being small for gestational age (SGA) were calculated for the first and last ultrasound estimations of fetal weight. Results: Our cohort included 75 cases of gastroschisis. At the initial ultrasound estimation, 15 of 58 (25.9%) fetuses met criteria for FGR; 48 of 70 (68.6%) met criteria at the time of the last ultrasound estimation (median, 34.7 weeks). Cesarean delivery was performed for 37 of 75 (49.3%), with FGR and concern for fetal distress as the indication for delivery in 17 of 37 (45.9%). Only 6 of 17 (35.3%) of the neonates born by cesarean delivery for an indication of FGR and fetal distress were SGA. The initial ultrasound designation of FGR corresponded to SGA at birth in 8 of 15 (53.3%), whereas the last ultrasound estimation corresponded to SGA in 17 of 48 (35.4%). The initial ultrasound estimation agreed with the last ultrasound estimation before delivery with the diagnosis of FGR in 13 of 15 (86.7%). Conclusions: Ultrasound in the third trimester was sensitive but had a low positive predictive value and low accuracy for the diagnosis of SGA at birth for fetuses with gastroschisis. A large proportion of fetuses were born by cesarean delivery with indications related to FGR or fetal concerns. [ABSTRACT FROM AUTHOR]

Published
2021
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378. Impact of the volume of the myelomeningocele sac on imaging, prenatal neurosurgery and motor outcomes: a retrospective cohort study.

Author

Corroenne, Romain, Mehollin-Ray, Amy R., Johnson, Rebecca M., Whitehead, William E., Espinoza, Jimmy, Castillo, Jonathan, Castillo, Heidi, Orman, Gunes, Donepudi, Roopali, Huisman, Thierry A. G. M., Nassr, Ahmed A., Belfort, Michael A., Sanz Cortes, Magdalena, and Shamshirsaz, Alireza A.

Subjects
MYELOMENINGOCELE, NEUROSURGERY, RANDOMIZED controlled trials, ANKLE, MOTOR ability
Abstract

To investigate the association of the myelomeningocele (MMC) volume with prenatal and postnatal motor function (MF) in cases who underwent a prenatal repair. Retrospective cohort study (11/2011 to 03/2019) of 63 patients who underwent a prenatal MMC repair (37 fetoscopic, 26 open-hysterotomy). At referral, measurements of the volume of MMC was performed based on ultrasound scans. A large MMC was defined as greater than the optimal volume threshold (ROC analysis) for the prediction of intact MF at referral (2.7 cc). Prenatal or postnatal intact motor function (S1) was defined as the observation of plantar flexion of the ankle based on ultrasound scan or postnatal examination. 23/63 participants presented a large MMC. Large MMC lesions was associated with an increased risk of having clubfeet by 9.5 times (CI%95[2.1–41.8], p < 0.01), and reduces the chances of having an intact MF at referral by 0.19 times (CI%95[0.1–0.6], p < 0.01). At birth, a large MMC reduces the chance of having an intact MF by 0.09 times (CI%95[0.01–0.49], p < 0.01), and increases the risk of having clubfeet by 3.7 times (CI%95[0.8–18.3], p = 0.11). A lower proportion of intact MF and a higher proportion of clubfeet pre- or postnatally were observed in cases with a large MMC sac who underwent a prenatal repair. Trial registration: Clinicaltrials.gov NCT02230072 and NCT03794011 registered on September 3rd, 2014 and January 4th, 2019. [ABSTRACT FROM AUTHOR]

Published
2021
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384. Postoperative imaging following fetal open myelomeningocele repair: The clinical utility of magnetic resonance imaging and sonographic amniotic fluid volumes in detecting suspected hysterotomy scar dehiscence

Author

Seaman, Rachel D., primary, Cassady, Christopher I., additional, Yepez Donado, Mayel C., additional, Espinoza, Jimmy, additional, Shamshirsaz, Alireza A., additional, Nassr, Ahmed A., additional, Whitehead, William E., additional, Belfort, Michael A., additional, and Sanz Cortes, Magdalena, additional

Published
2019
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385. Maternal outcomes in unexpected placenta accreta spectrum disorders: single-center experience with a multidisciplinary team

Author

Erfani, Hadi, primary, Fox, Karin A., additional, Clark, Steven L., additional, Rac, Martha, additional, Rocky Hui, Shiu-Ki, additional, Rezaei, Atefeh, additional, Aalipour, Soroush, additional, Shamshirsaz, Amir A., additional, Nassr, Ahmed A., additional, Salmanian, Bahram, additional, Stewart, Kelsey A., additional, Kravitz, Elizabeth S., additional, Eppes, Catherine, additional, Coburn, Michael, additional, Espinoza, Jimmy, additional, Teruya, Jun, additional, Belfort, Michael A., additional, and Shamshirsaz, Alireza A., additional

Published
2019
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388. Population-Based Estimation of Dental Caries and Periodontal Disease Rates of Gravid and Recently Postpartum Women in Lilongwe, Malawi

Author

Antony, Kathleen M., additional, Kazembe, Peter N., additional, Pace, Ryan M., additional, Levison, Judy, additional, Mlotha-Namarika, Jesse, additional, Phiri, Henry, additional, Chiudzu, Grace, additional, Harris, R. Alan, additional, Aagaard, Joshua, additional, Twyman, Nicholas, additional, Ramin, Susan M., additional, Raine, Susan P., additional, Belfort, Michael A., additional, and Aagaard, Kjersti M., additional

Published
2019
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389. Evaluation and Disposition of Fetal Myelomeningocele Repair Candidates: A Large Referral Center Experience

Author

Pan, Evelyn T., primary, Pallapati, Joana, additional, Krueger, Angel, additional, Yepez, Mayel, additional, VanLoh, Sarah, additional, Nassr, Ahmed A., additional, Espinoza, Jimmy, additional, Shamshirsaz, Alireza A., additional, Olutoye, Oluyinka O., additional, Mehollin-Ray, Amy, additional, de Jong, Hester, additional, Castillo, Heidi, additional, Castillo, Jonathan, additional, Whitehead, William E., additional, Olutoye, Olutoyin A., additional, Ayres, Nancy, additional, Belfort, Michael A., additional, and Sanz Cortes, Magdalena, additional

Published
2019
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390. Coagulopathy in surgical management of placenta accreta spectrum

Author

Shamshirsaz, Alireza A., primary, Fox, Karin A., additional, Erfani, Hadi, additional, Clark, Steven L., additional, Hui, Shiu-Ki, additional, Shamshirsaz, Amir A., additional, Rezaei, Atefeh, additional, Nassr, Ahmed A., additional, Lake, Yasmin N., additional, Teruya, Jun, additional, and Belfort, Michael A., additional

Published
2019
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391. Obstetric outcomes of ex‐utero intrapartum treatment (EXIT)

Author

Shamshirsaz, Alireza A., primary, Aalipour, Soroush, additional, Erfani, Hadi, additional, Nassr, Ahmed A., additional, Stewart, Kelsey A., additional, Kravitz, Elizabeth S., additional, Rezaei, Atefeh, additional, Sanz Cortes, Magdalena, additional, Espinoza, Jimmy, additional, and Belfort, Michael A., additional

Published
2019
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396. Surgical interventions and anesthesia in the 1st year of life for lower urinary tract obstruction

Author

Puttmann, Kathleen T., primary, White, Jeffrey T., additional, Huang, Gene O., additional, Sheth, Kunj, additional, Elizondo, Rodolfo, additional, Zhu, Huirong, additional, Braun, Michael C., additional, Mann, David G., additional, Olutoye, Olutoyin A., additional, Tu, Duong D., additional, Ruano, Rodrigo, additional, Belfort, Michael, additional, Brandt, Mary L., additional, Roth, David R., additional, and Koh, Chester J., additional

Published
2019
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397. Utilization and outcomes of massive transfusion protocols in women with and without invasive placentation

Author

Shainker, Scott, primary, Shamshirsaz, Alireza, additional, Haviland, Miriam, additional, O’Brien, Kerry, additional, Redhunt, Allyson, additional, Bateni, Zhoobin, additional, Moaddab, Amirhossein, additional, Fox, Karin, additional, Hui, Shiu-Ki, additional, Belfort, Michael, additional, Dildy, Gary, additional, and Hacker, Michele, additional

Published
2019
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398. Cervical lymphatic malformations: Prenatal characteristics and ex utero intrapartum treatment

Author

Shamshirsaz, Alireza A., primary, Stewart, Kelsey A., additional, Erfani, Hadi, additional, Nassr, Ahmed A., additional, Sundgren, Nathan C., additional, Mehollin‐Ray, Amy R., additional, Morris, Shaine A., additional, Espinoza, Jimmy, additional, Sanz Cortes, Magdalena, additional, Cassady, Christopher, additional, Lee, Timothy C., additional, Castro, Eumenia C., additional, Olutoye, Olutoyin A., additional, Mehta, Deepak K., additional, Cass, Darrell, additional, Olutoye, Oluyinka O., additional, and Belfort, Michael A., additional

Published
2019
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400. Amniotic membrane and placental histopathological findings after open and fetoscopic prenatal neural tube defect repair

Author

Sanz Cortes, Magdalena, primary, Castro, Eumenia, additional, Sharhan, Dina, additional, Torres, Paola, additional, Yepez, Mayel, additional, Espinoza, Jimmy, additional, Shamshirsaz, Alireza A., additional, Nassr, Ahmed A., additional, Popek, Edwina, additional, Whitehead, William, additional, and Belfort, Michael A., additional

Published
2019
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