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Study in the American Journal of Obstetrics & Gynecology finds Glucose Supplementation Significantly Reduces Length of Induced Labor in Childbirth

WASHINGTON (Feb. 13, 2017)—A study in the American Journal of Obstetrics & Gynecology finds that simple glucose supplementation reduces length of induced labor. The study (currently available online as an Article in Press, in advance of the May issue of the Journal), was initially presented two weeks ago at the Society for Maternal-Fetal Medicine’s annual More »

Charles J. Lockwood, M.D. Recognized with Lifetime Achievement Award from the Society for Maternal-Fetal Medicine

WASHINGTON, Feb. 7, 2017—The Society for Maternal-Fetal Medicine surprised Charles (Charly) J. Lockwood, M.D., MHCM, last week when they gave him the SMFM Lifetime Achievement Award at the SMFM annual meeting in Las Vegas. “Dr. Lockwood was selected because he really has had a remarkable career,” said SMFM President Mary Norton, M.D., who presented Lockwood More »

Study Found Brain Abnormalities in Fetuses Exposed to Zika

LAS VEGAS (Jan. 23, 2017)—In a study to be presented Friday, Jan. 27, in the oral concurrent session at 1:15 p.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™, researchers with the Baylor College of Medicine Department of Obstetrics and Gynecology, Houston, Texas partnered with the Maternal-Fetal Unit, CEDIFETAL, Centro de More »

Improving Birthing Deliveries with Less Physical Trauma to Mom and Baby

LAS VEGAS (Jan. 23, 2017)—In a study to be presented Friday, Jan. 27, in the oral concurrent session at 1:15 p.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™, researchers with Community Medical Center in Missoula, Montana; Uniformed Services University of the Health Sciences, Bethesda, Md.; and Wilford Hall Ambulatory Surgery More »

New Health Care Model Cut Costs and Reduced Need for Medical Services for Pregnant Women and Newborns

LAS VEGAS (Jan. 23, 2017)—In a study to be presented Friday, Jan. 27, in the oral concurrent session at 1:15 p.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™, researchers will present their findings for a study titled, Pregnancy medical home: Outcomes and cost-savings. The study set out to evaluate the More »

Scientists Say Mom’s Cervical Bacterial May be Key to Preventing Premature Birth

LAS VEGAS, JAN. 23, 2017 – A team of researchers that has confirmed the presence of bacteria in a woman’s vagina and cervix may either increase the risk of premature birth or have a protective effect against it, has won the March of Dimes Award for Best Abstract on Prematurity at the Society for Maternal-Fetal More »

Study in the American Journal of Obstetrics & Gynecology finds Glucose Supplementation Significantly Reduces Length of Induced Labor in Childbirth

WASHINGTON (Feb. 13, 2017)—A study in the American Journal of Obstetrics & Gynecology finds that simple glucose supplementation reduces length of induced labor. The study (currently available online as an Article in Press, in advance of the May issue of the Journal), was initially presented two weeks ago at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™. The study, “Reduction of total labor length through the addition of parenteral dextrose solution in induction of labor in nulliparous: results of DEXTRONS prospective randomized controlled trial,” was conducted by researchers with the Université de Sherbrooke in Sherbrooke, Quebec, Canada. The study investigated the use of glucose to shorten induced labor in nulliparous (first time giving birth). The primary outcome studied was the total length of active labor.

Prolonged labor can be harmful to maternal and fetal health. Few medical interventions are known to shorten labor duration. Because muscle performance is known to be improved by glucose supplementation, the researchers tested whether adding glucose to the intravenous hydration solution women receive during labor could accelerate labor. Two hundred pregnant women were randomly assigned to receive either a standard hydration solution containing salt and water or a solution containing glucose, salt and water.

Josianne Pare, M.D., with the Department of Obstetrics & Gynecology at the University of Sherbrooke and the presenter of the research at the SMFM annual meeting, explained, “We found that the median duration of labor was 76 minutes shorter in the group of women receiving glucose. There was no difference in the mode of delivery (cesarean section, forceps, etc.), or the neonatal well-being measures.” Pare continued, “Glucose supplementation therefore significantly reduces the total length of labor without increasing the rate of complication. This is great news for women experiencing induced labor.”

The researchers concluded that, given the low-cost and safety of this intervention, glucose should be the solute of choice during labor.

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Charles J. Lockwood, M.D. Recognized with Lifetime Achievement Award from the Society for Maternal-Fetal Medicine

WASHINGTON, Feb. 7, 2017—The Society for Maternal-Fetal Medicine surprised Charles (Charly) J. Lockwood, M.D., MHCM, last week when they gave him the SMFM Lifetime Achievement Award at the SMFM annual meeting in Las Vegas.

“Dr. Lockwood was selected because he really has had a remarkable career,” said SMFM President Mary Norton, M.D., who presented Lockwood with the award. “He has been very successful in research and rose to leadership roles from very early in his career.” She continued, “One of his greatest strengths is in teaching and mentoring—both of which he has done to a remarkable degree. He has mentored a large number of Ob/Gyn and MFM physicians, many of whom have risen to leadership roles.”

Lockwood is currently the senior vice president of USF Health and dean of Morsani College of Medicine at the University of South Florida in Tampa; he is a professor in the medical school’s department of obstetrics and gynecology; and professor of health policy and management at the USF College of Public Health. He is also the obstetrics section editor for UpToDate and Editor-in-Chief of Contemporary OB/GYN; and serves as the president elect of the American Gynecological and Obstetrical Society.

He earned a Bachelor of Science, magna cum laude with distinction from Brown University and his medical degree from the University of Pennsylvania School of Medicine. He holds a Master of Science in Health Care Management degree from the Harvard School of Public Health. Lockwood served his residency in obstetrics and gynecology at Pennsylvania Hospital and his fellowship in maternal-fetal medicine at the Yale—New Haven Hospital.

Lockwood is internationally known for his research expertise in obstetrics and gynecology and has been credited with leading a research team that discovered fetal fibronectin, the first biochemical predictor of prematurity. He has also made major discoveries in the field of endometrial biology. He is a prolific writer, having written 290 peer-reviewed publications and 170 editorials, written or co-written three books and co-edited seven major textbooks.

Lockwood is the recipient of multiple research grant awards from the National Institutes of Health and the March of Dimes and other foundations. His clinical interests include the prevention of recurrent pregnancy loss, preterm delivery and maternal thrombosis and he maintains an active research lab at USF Health. He helped launch the Pregnancy Loss Prevention Center in Tampa, Florida.

Lockwood is a member of the Sigma Xi and Alpha Omega Alpha honor societies, was elected a fellow of the American Association for the Advancement of Science and a member of the National Academy of Medicine (Institute of Medicine). He has also been cited on numerous “Best Doctors” lists for the last two decades, and he is actively involved with the American Heart Association and the March of Dimes.

The SMFM Lifetime Achievement Award is given to physicians who have made a lasting and significant impact on the field of maternal-fetal medicine. “Dr. Lockwood has accomplished so much, helped so many in our field and earned the respect of fellow researchers and physicians while making a huge contribution to the lives of expecting families and their babies,” Norton added. “It is a great honor for me to present him with this award.”

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Study Found Brain Abnormalities in Fetuses Exposed to Zika

LAS VEGAS (Jan. 23, 2017)—In a study to be presented Friday, Jan. 27, in the oral concurrent session at 1:15 p.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™, researchers with the Baylor College of Medicine Department of Obstetrics and Gynecology, Houston, Texas partnered with the Maternal-Fetal Unit, CEDIFETAL, Centro de Diagnostico de Ultrasonido e Imagenes, CEDIUL, Barranquilla, Columbia and the Unidad De Fertildad  Y Genetica De Cartagena, Cartagena de Indias, Columbia, to create the study, Characterization of brain malformations and volume assessment in fetuses with Zika Virus infection using MRI.

Researchers assessed fetal brain findings and volumetric composition with magnetic resonance imaging (MRI) of confirmed Zika virus infected fetuses from the recent outbreak in Barranquilla, Columbia.  The fetuses were screened throughout gestation, finding brian anomalies at 29 weeks gestation.

“Up until our study, there have not been any reports focused on detailed brain imaging from the Zika outbreak in Colombia,” stated Magdalena Sanz-Cortes, M.D., Ph.D. with Baylor College of Medicine’s department of obstetrics and gynecology, maternal-fetal medicine specialist at Texas Children’s Pavilion for Women and presenter of the study at the SMFM annual meeting. The researchers found a reduction in brain tissue and increased amount of fluid that was most pronounced in the upper brain. “Microcephaly does not happen in all Zika cases,” Sanz-Cortes explained, referring to the small head size that has been characterized as a Zika symptom. The findings were similar to the findings of infected babies in Brazil.

“This research has filled a gap of knowledge for us,” Sanz-Cortes continued, “these results support the recent notion that we should not rely on microcephaly to determine if a fetus or newborn has contracted the Zika Virus.”

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Improving Birthing Deliveries with Less Physical Trauma to Mom and Baby

LAS VEGAS (Jan. 23, 2017)—In a study to be presented Friday, Jan. 27, in the oral concurrent session at 1:15 p.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™, researchers with Community Medical Center in Missoula, Montana; Uniformed Services University of the Health Sciences, Bethesda, Md.; and Wilford Hall Ambulatory Surgery Center, San Antonio, Texas, will present their study titled, SAFE PASSAGES implementation reduces perineal trauma.

In 2013, the Department of Defense participated in the Partnership for Patients program to reduce iatrogenic (caused inadvertently by a physician or surgeon or by medical treatment or diagnostic procedure) patient harm. Recognizing that some of the trauma and tears associated with labor could be reduced, a specific program for harm reduction was developed called SAFE PASSAGES. The SAFE PASSAGES term is memory prompt for a series of interventions for managing childbirth that reduce the chances and severity of childbirth trauma.  For example the first “E” is “Eliminate midline episiotomy”.  One military service used this program and other two services instituted other programs that encouraged reduced rates of harm in childbirth but offered no specific programmatic recommendations for reduction. This study evaluated the effectiveness of SAFE PASSAGES training on the incidence of perineal trauma in the Department of Defense.

Of the three programs reviewed, SAFE PASSAGES showed the greatest reduction in the rate of harm (63.6%) at the same time having a decrease in cesarean delivery rates.  At hospitals where the SAFE PASSAGES program was implemented with on-site didactic and simulation training, the rate of severe perineal lacerations was reduced by over 300%.

“I believe that the principles taught and propagated in the SAFE PASSAGES program could go a long way toward keeping the cesarean rate down, even improving the rate, while reducing the overall risk of trauma in child birth” stated Merlin B. Fausett, M.D., maternal-fetal medicine specialist with the Community Medical Center and the presenter of the research at the SMFM annual meeting. Dr. Fausett continued, “If one considers a cesarean as trauma, these principles can really help reduce the risk of trauma to mother either through avoiding unnecessary cesareans or reducing trauma in vaginal birth while even potentially reducing the risk of trauma to babies as well. The program includes training in support of forceps and vacuum deliveries and quality repair of tears when they do occur.  This study definitively shows that applying the techniques taught in the SAFE PASSAGES program can really help to reduce the risk of harm to mother and baby during childbirth.”

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New Health Care Model Cut Costs and Reduced Need for Medical Services for Pregnant Women and Newborns

LAS VEGAS (Jan. 23, 2017)—In a study to be presented Friday, Jan. 27, in the oral concurrent session at 1:15 p.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™, researchers will present their findings for a study titled, Pregnancy medical home: Outcomes and cost-savings.

The study set out to evaluate the impact of a pregnancy medical home model on the utilization of emergency services and hospital days in a low-income population. Texas Children’s Health Plan and Baylor College of Medicine partnered to create a new health care model in Houston, Texas. The principles of patient-centered care found in a primary care medical home were expanded to include obstetrics and gynecology, creating a pregnancy medical home exclusively for women and children covered by Medicaid and the Children’s Health Insurance Program (Chip).

The medical home integrates obstetrics/gynecology, maternal-fetal medicine, pediatrics, behavioral health, optometry, dentistry, radiology, laboratory and pharmacy—all in one location. The home provides team-based care with midwives and physicians in the clinic and a hospitalist model for inpatient care. Extended hours (66 hours per week for OB and 100 hours per week for pediatrics) and walk-in/same day appointments provide opportunities to avoid unnecessary emergency room visits.

The researchers compared this care model with traditional obstetric care and found that women receiving care at the medical home were significantly less likely to utilize the emergency room and also spent significantly fewer days in the hospital. In addition, their newborns spent significantly fewer days in the hospital and were less likely to utilize the emergency room.

“The decreased need to use these services resulted in an estimated annual savings of over $800,000 for pregnant women and over $1.6 million for newborns,” explained Lisa Hollier, M.D., professor of obstetrics and gynecology for Baylor College of Medicine and one of the researchers of the study to be presented at the SMFM annual meeting.  “We believe this model can readily serve as a national model for improved health care, substantial savings and improved outcomes,” Hollier added.

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Scientists Say Mom’s Cervical Bacterial May be Key to Preventing Premature Birth

LAS VEGAS, JAN. 23, 2017 – A team of researchers that has confirmed the presence of bacteria in a woman’s vagina and cervix may either increase the risk of premature birth or have a protective effect against it, has won the March of Dimes Award for Best Abstract on Prematurity at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™. The findings will be presented Thursday, January 26, at 1:15 p.m. PST at Caesars Palace Augustus Ballroom in Las Vegas.

Michal Elovitz, M.D., and colleagues at the Perelman School of Medicine at the University of Pennsylvania and the University of Maryland studied 2,000 pregnant women, taking vaginal swabs at three distinct time points in pregnancy, and performed analyses on the specimens to determine the microbial colonies that were present. They found that the presence of many bacteria actually conferred a lower risk of spontaneous preterm birth while other bacteria were associated with a significant increased risk. The bacteria associated with spontaneous preterm birth, in conferring either protection or risk, were different between African-American and non-African-American women.

Premature birth (before 37 weeks of pregnancy) is the #1 killer of babies in the United States and the leading cause of death in children under age 5 around the world. Babies who survive an early birth often face serious and lifelong health problems, including breathing problems, jaundice, vision loss, cerebral palsy and intellectual delays. In addition to the human toll, preterm birth accounts for more than $26 billion annually in avoidable medical and societal costs, according to the National Academy of Medicine.

Dr. Elovitz, who is professor of Obstetrics and Gynecology at the University of Pennsylvania, vice chair of Translational Research and Director of the Maternal and Child Health Research Center at PENN, says doctors have been frustrated by the lack of treatments that reliably prevent premature birth. Furthermore, she says, clinicians currently have no good screening test to determine which women are at highest risk for preterm birth. In the quest for a new approach to the problem of prematurity, she began to engage with leading researchers in other fields such as bioengineering, immunology, pharmacology and microbiology.

“Although conventional wisdom says premature birth begins in the uterus, we decided to take an entirely new look at the problem,” she says.

Dr. Elovitz and her colleagues decided to investigate whether the initiation of preterm birth might begin in the cervicovaginal space, specifically leading to early changes in the cervix. “We started with the hypothesis that there is some difference in the molecular, biological, biochemical and/or microbial events in cervicovaginal space in women who ultimately have a premature birth compared to women who ultimately have a full term baby,” she says. Dr. Elovitz has been able to pursue this line of research as a co-investigator for the March of Dimes Prematurity Research Center at the University of Pennsylvania as well as through her National Institutes of Health funded studies.

In a study titled “Motherhood and the Microbiome,” funded by the National Institute of Nursing Research, Dr. Elovitz and her team were able to target one part of this hypothesis by studying the cervicovaginal microbial communities in a large prospective cohort of pregnant women.  “We are very excited to report that we did find significant differences in the microbial communities early in pregnancy in women who ultimately have a preterm birth compared to a term birth,” she says. “Different bacterial species were associated with quite a dramatic increased risk of premature birth. If our study is confirmed, it could mean that targeting CV bacteria may be a new therapy to prevent premature birth in the immediate future, not decades from now.”

Edward R.B. McCabe, MD, PhD, senior vice president and chief medical officer of the March of Dimes, agreed. “From these data, we may learn how to prevent preterm birth either by eliminating the CV bacteria that are associated with an increased risk and/or by enhancing the presence of protective bacteria. This is a promising new area that should become a research priority,” he says.

The team receiving the March of Dimes award includes Michal Elovitz, Pawel Gajer, Katheryne Downes and Jacques Ravel.

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Study Looks at How Changes in Maternal Diet Impact Human Milk Oligosaccharides and the Milk Microbiome

LAS VEGAS (Jan. 23, 2017)—In a study to be presented Thursday, Jan. 26, in the oral plenary session at 1:15 p.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™, researchers with Baylor College of Medicine, Houston, Texas and University of California, San Diego, La Jolla, California, will present their findings on a study titled, Maternal Diet Structures the Breast Milk Microbiome in Association with Human Milk Oligosaccharides and Gut-Associated Bacteria.

Previous studies have shown that a high fat maternal diet during gestation and lactation has a long-term impact on the infant’s gut microbiome (the community of bacteria living inside the human gut.)  This study represents the first step in understanding whether breast milk contributes to this process.

In this study, researchers found that specific changes to maternal diet in the same woman (changing fat versus carbohydrate consumption, or changing consumption of specific sugars), is associated with changes in both the milk microbiome and human milk oligosaccharide (a carbohydrate) composition.  Given that these two components of breast milk have the potential to alter the gut microbiome of breast-feeding infants, the results of the study suggest that development of the infant gut microbiome may be affected in part by what the mother eats during breastfeeding.

“Further studies are needed to delineate if specific changes in maternal diet during breast-feeding alter the infant gut microbiome and to determine if this results in any health consequences for the infant,” said Kristen Meyer, in the Department of Obstetrics and Gynecology at Baylor College of Medicine and the presenter of the study at the SMFM annual conference. “Ultimately, we would hope that future studies would form dietary guidelines for breastfeeding mothers to promote healthy development of their infants’ gut microbiota,” Meyer added.

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Evaluation of Recombinant Antithrombin Versus Placebo in Preterm Preeclampsia

LAS VEGAS (Jan. 23, 2017)—In a study to be presented Friday, Jan. 27, in the late breaking oral session at 10 a.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™, researchers with The PRESERVE-1 Study Group University of Texas Health Science Center at Houston—McGovern Medical School, Houston, Texas, and Yale School of Medicine, New Haven, Connecticut, present findings of a study titled Randomized double-blind placebo controlled evaluation of the safety and efficacy of recombinant Antithrombin versus placebo in preterm preeclampsia. The study was sponsored by rEVO Biologics, Inc.

Preeclampsia is a major cause of maternal and perinatal mortality and morbidity. In addition, women who develop early onset preeclampsia have markedly increased rate of complications both acute and long term such as cardiovascular disease, stroke, renal injury and metabolic syndrome. Infants born at less than 30 weeks have significant neonatal complications with prolonged stays in the neonatal intensive care unit. In addition, they are at increased risk for chronic lung disease, cerebral palsy and other neurologic deficits. There are approximately 8,000 cases of early onset preeclampsia each year in the U.S. The estimated maternal and neonatal cost of these pregnancies is almost $1.5 billion.

This trial investigated the effects of recombinant antithrombin (ATryn®), a man-made version of antithrombin, a protein molecule found in blood that is produced by the liver, regulates the coagulation system, and has anti-inflammatory properties. It was studied to determine its potential to prolong gestation and improve maternal and neonatal outcomes. The study’s design was remarkable in that it was the largest randomized, controlled trial ever to be completed in patients who developed preeclampsia very early in pregnancy, 23-30 weeks’ gestational age.

Baha Sibai, M.D. with the University of Texas Health Science Center at Houston and the presenter of the study at the SMFM annual meeting, reported “The results found no improvement in outcomes with such therapy.  There were no reported safety events related to Recombinant Antithrombin” Future studies should investigate different novel targeted therapies to improve outcome in such pregnancies.”

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Identifying Early Markers of Cardiac Dysfunction in Pregnancy

LAS VEGAS (Jan. 23, 2017)—In a study to be presented Friday, Jan. 27, in the oral concurrent session at 1:15 p.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™, researchers with the Maternal and Child Health Research Center and the Department of Cardiology at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, will present findings of a study titled Cardiac Dysfunction in Preeclampsia is Present at Diagnosis and Persists Postpartum.

Preeclampsia, which affects 3-8 percent of all pregnancies, is a disease specific to pregnancy that is characterized by high blood pressure and protein in the urine. Research studies have clearly shown that there is a link between a history of preeclampsia in a pregnancy and developing heart disease later in life. In fact, a history of preeclampsia is as much of a risk factor for heart disease as a lifetime of smoking cigarettes and the American Heart Association now screens women specifically for a history of preeclampsia. The issue is that, while this association is clearly known, not all women with a history of preeclampsia will develop heart disease. Additionally, we do not know the exact process that takes place from the time women experience preeclampsia to the ultimate development of heart disease.

This research looked at women with and without preeclampsia in a pregnancy and performed echocardiograms on them (ultrasounds of the heart) to see if they could identify which women are at highest risk of developing heart disease later in life by identifying early signs (during the pregnancy and within the six weeks postpartum) of an abnormal heart. Since the majority of heart disease does not occur until decades after experiencing preeclampsia, identifying early cardiac changes could potentially lead to early interventions that decrease the long-term risk.

Lisa Levine, M.D., MSCE, assistant professor of Obstetrics and Gynecology at the Perelman School of Medicine at the University of Pennsylvania, and the presenter of the study at the SMFM annual meeting, explained, “Specifically for women with preeclampsia – the study has shown that there are signs of heart changes that can be identified in these women as early as the time they are diagnosed with the condition and identifies the importance of close follow-up of these women to ensure appropriate heart health for the future.”

Studies have shown that African-American women are at a higher risk of preeclampsia as well as a higher risk of heart disease.  Because a large population of the researchers’ institution patients are African-American, they made up more than 80 percent of the study. Researchers also noted that preeclampsia disproportionately affects African-American women compared to other races and therefore is one of the reasons for the high percentage in the study.

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Thousands of Maternal-Fetal Medicine Physician Specialists will Meet in Las Vegas Next Week

WASHINGTON (Jan. 18, 2017)—Las Vegas Mayor Carolyn Goodman issued a proclamation declaring Jan. 23 to 28 “Society for Maternal-Fetal Medicine Week,” when more than 2,000 maternal-fetal medicine specialists (high-risk pregnancy physicians) will gather in Las Vegas for the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™. In the proclamation, the Mayor asks the city and all citizens “to join me, a proud daughter of a pregnancy physician, in wishing the members of SMFM a wonderful annual meeting and stay in Las Vegas and to offer thanks for their charitable endeavors and for their amazing work in this most important field of high-risk pregnancy.”

At the SMFM meeting, researchers from around the world will present their findings on important topics such as the reduction of premature birth (the U.S. maintains a high premature birth rate globally), reduction of cesarean sections, using pregnancy as a window on future health, genetic testing and Zika Virus, as well as others.

The SMFM annual meeting has become known for its groundbreaking research presentations. This year, more than 2100 research applications were submitted with 117 of the research presentations and 875 of the posters being accepted. “This meeting has become an important place for the exchange of research, thought leadership, protocol and discussion,” stated Robert Silver, M.D., chief of the division of maternal-fetal medicine at the University of Utah Health Care and the SMFM conference chair.

In addition, Rancho High School (Las Vegas) students interested in health care will attend the oral plenary sessions at the SMFM annual meeting Thursday a.m. (8 a.m. Augustus Ballroom at Caesars Palace, 3570 S Las Vegas Blvd., Las Vegas) and will be assigned to a physician mentor. They will be able to attend the abstract presentations and then meet with the physician following the sessions to get more information and ask questions. “We wanted to be able to inspire children in the area who are interested in pursuing the health care field,” explained Brian Iriye, M.D, a maternal-fetal medicine specialist and managing partner of the High Risk Pregnancy Center in Las Vegas. “Maternal-fetal medicine is an exciting field and this is a great opportunity to educate high school students on the  opportunities and rewards of this profession,” Iriye added.

A special, no-cost session, The Latest on Critical Issue in Obstetric Care, will be held Saturday, Jan. 28, from 1 to 5 p.m. in the Caesars Palace Milano IV room for area obstetricians, general and family practice physicians and nurses. The session will cover evaluation of the Zika virus in pregnant patients as well as counseling and care; optimal management of postpartum hemorrhage, identification of placenta accreta and appropriate care; understanding use of cell free DNA screening tests; which patients benefit from progesterone treatment and determining optimal treatment of preterm labor in multiple gestations. To attend, go to http://svy.mk/2ipfj61and fill in the form or contact Vicki Bendure at Vicki@Bendurepr.com.

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Comparing Skin Closure Options for Cesarean Delivery to Determine which Method Causes the Least Wound Complications

LAS VEGAS (Jan. 23, 2017)—In a study to be presented Thursday, Jan. 26, in the oral concurrent session at 1:15 p.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™, researchers with the Albert Einstein College of Medicine/Montefiore Medical Center in Bronx, New York, will present their findings in a study titled, Comparison of subcuticular suture type in post-cesarean wound complications: a randomized controlled trial. In the study researchers tested two types of sutures—poliglecaprone 25 (monocryl® suture) and polyglactin 910 (vicryl® suture).  Monocryl is an absorbable, single filament suture with low tissue reactivity which dissolves slowly and loses strength. Vicryl is an absorbable, braided suture with low tissue reactivity which dissolves quickly but maintains strength.

Over the course of 14 months, 550 patients were randomized with 275 receiving monocryl suture and 275 receiving vicryl. Patients studied were those undergoing non-emergency cesarean deliveries at 37 weeks gestation or longer and there was no significant difference in demographic information (age, body mass index, ethnicity, gestational age, gravidity, parity) between the two study groups. Patients were followed for complications until their six-week postpartum visit. The primary outcome was wound complications within the first 30 days following delivery. Complications included the incision reopening, hematoma, swelling, fluid gathering around the incision and/or infection.

Arin Buresch, M.D., with Albert Einstein College of Medicine and the presenter of the study at the SMFM annual meeting, said, “We found that monocryl suture had a significantly decreased rate of wound complications compared to the vicryl suture.”   She went on to explain, “The difference in wound complications may occur due to the braiding in vicryl suture which conceivably allows bacterial growth in small nooks and crevices. In the future, we hope our study will help guide the decision-making on which suture type is used when closing the skin in cesarean births.”

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Evaluation of the Use of Human Umbilical Cord for In-Utero Spina Bifida Repair

LAS VEGAS (Jan. 23, 2017)—In two studies to be presented Saturday, Jan. 28, in the oral concurrent session at 8:45 a.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™, researchers evaluated a possible regenerative patch by using human umbilical cord in two studies titled Cryopreserved Human Umbilical Cord (HUC) vs Acellular Dermal Matrix (ADM) for In-Utero Spina Bifida Repair and the study Conventional vs cryopreserved human umbilical cord (HUC) patch based on repair for in-utero spina bifida in a sheep model.

Spina Bifida is a birth defect where there is an incomplete closure of the backbone and the coverings around the spinal cord. It affects more than 4,000 children born each year in the United States and is associated with hydrocephalus (fluid in the brain), developmental delay, lifelong disability and death.

Spina Bifida is also associated with a need for shunt placement. In-utero surgery has been shown to reduce the need for shunting of hydrocephalus and to improve a child’s ability to walk. However, more than half of the children who undergo such surgery do not benefit from the in-utero repair, which failure has been attributed to suboptimal repair leading to persistent leakage of cerebrospinal fluid and spinal cord scar formation at the repair site.

Researchers are trying to identify a regenerative patch material for repair that would further reduce morbidity after repair through decreased spinal cord damage from reduced inflammation and scar formation.

In the first study, conducted in a pregnant rat model, the researchers sought to compare two types of patches: a cryopreserved human umbilical cord patch and an acellular dermal matrix, a currently used graft material in clinical practice. The scientists aimed to explore the cellular response in both inflammatory and regenerative properties after in-utero repair in a fetus.  The cryopreserved human umbilical cord patch was determined to promote organized cellular migration of epidermal and meningeal cells and decrease acute inflammatory response and cell death compared to the acellular dermal matrix.

In the second study, conducted in a pregnant sheep model, the researchers compared the cryopreserved human umbilical cord patch to the current method of closure using sutures on the defect to test the functional and structural preservation of spinal cord at the repair site. The lambs repaired using cryopreserved human umbilical cord showed improved spinal cord function with decreased meningeal scar formation and better preservation of the spinal cord tracts.

Although these studies were preclinical, the human umbilical cord patch shows promising results to improve outcomes in spina bifida birth defects. Researchers worked with experienced veterinary staff who observed the animals daily for any complications. These animal studies were reviewed and approved by The University of Texas Health Science Center at Houston (UTHealth) Animal Welfare Committee as scientifically justified and appropriate.

“The unmet clinical need in in-utero spina bifida repair is the optimal closure method to reduce the ongoing damage to the spinal cord from inflammation and scar formation and to promote continued fetal spinal cord development. Based on the safety and efficacy of the cryopreserved human umbilical cord patch for in-utero spina bifida in pregnant rats and sheep, we have performed four cases of in-utero human repair under FDA approval. The early results have been promising, and the studies are ongoing to evaluate the long-term benefits in these patients. We believe that this is an initial step toward a safe and minimally invasive in-utero spina bifida repair,” said Ramesha Papanna, M.D., M.P.H., the principal investigator of the projects at The Fetal Center at Children’s Memorial Hermann Hospital and McGovern Medical School at UTHealth, who is also the presenter of one of the studies at the SMFM annual conference.

Lovepreet Mann, M.B.B.S., is a research instructor in the department of obstetrics and gynecology at McGovern Medical School and the co-investigator and the primary author who conducted experiments in the pregnant rat model in collaboration with Papanna.  Mann will present one of the studies at the SMFM annual meeting.

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Evaluation of the Effects of Laser Tissue Welding for Spina Bifida Repair

LAS VEGAS (Jan. 23, 2017)—In a study to be presented Saturday, Jan. 28, in the oral concurrent session at 8:45 a.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™, researchers at Baylor College of Medicine, Houston, Texas; IBEX, Logan, Utah; and Laser Tissue Welding Inc., Houston, Texas collaborated on a study titled, Evaluation of the effects of laser tissue welding on the spinal cord and skin in a 30 day study of simulated spina bifida repair in rabbits.

Spina Bifia is a birth defect where there is incomplete closure of the backbone and membranes around the spinal cord. It affects more than 4,000 children born each year in the U.S. and is associated with hydrocephalus (excessive accumulation of fluid on the brain), developmental delay, lifelong disability and death.

This preliminary study hoped to determine the effects of laser tissue welding on underlying skin and spinal cord tissue. The researchers were interested to see if applying laser energy to coagulate a special albumin compound would damage the underlying skin and/or spinal cord tissue.  The researchers plan to use this substance for sealing incision lines in fetal surgical spina bifida repair procedures.

One of the most crucial aspects of a fetal repair is a watertight seal once the repair is complete. “Laser tissue welding is a promising technology that may allow a temporary seal over healing wounds that allows enough time for the regeneration of the skin underneath the albumin layer,” explained Michael Belfort, M.D., chairman and professor of obstetrics and gynecology at Baylor College of Medicine, obstetrician/gynecologist-in-chief of Texas Children’s Pavilion for Women and one of the researchers for the presentation at the SMFM annual meeting. “By sealing off the incision line with a natural substance that disintegrates over time, we feel that the suture line may heal without developing any leaks which would compromise the repair.”

The first step in this experimental process examined whether the heat from the laser (required to activate the liquid albumin and turn it into a solid) would damage the skin or spinal tissue under the skin. Researchers chose a rabbit model because it is an accepted and cost efficient animal model and there was no need to test this in a fetal model until further research is conducted.

“This is just the first step,” added Belfort. “Now that we know that the laser energy is unlikely to damage spinal cord tissue we have planned a fetal sheep experiment. We are trying to get funding for this next step.”

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Study Finds an Association Between Day of Delivery and Maternal-Fetal Mortality

LAS VEGAS (Jan. 23, 2017)—In a study to be presented Friday, Jan. 27, in the oral concurrent session at 1:15 p.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™, researchers with the Baylor College of Medicine in Houston, Texas, presented the study titled Association between day and month of delivery with maternal-fetal mortality: weekend effect and July phenomenon in current obstetric practice.

Based on data from the Centers for Disease Control and Prevention, the United States maternal mortality ratio is three to four times higher than that of most other developed nations. The maternal mortality ratio is increasing, reaching 21-22 per 100,000 live births in 2014 (more than double from 1990.) Although much has been written about this problem, few solutions have been forthcoming.

The researchers of this study wanted to know if maternal and fetal death ratios were higher on weekends versus weekdays or during different months of the year. “We were interested in this study because we believe this data provides a valuable window into the problems with the U.S. system of obstetric care delivery,” said Amirhossein Moaddab, M.D., with the department of obstetrics and gynecology at Baylor College of Medicine and the presenter of the study at the SMFM annual meeting.

The researchers analyzed more than 45 million pregnancies in the U.S. between 2004 and 2014 to determine if there are significant differences in ratios of both maternal deaths and stillborn deliveries depending on the day they occurred. Weekend delivery is also associated with differential maternal and neonatal morbidity, including increased ratios of perineal lacerations, maternal transfusions, neonatal intensive care admissions, immediate neonatal ventilation requirements, neonatal seizures and antibiotic use.

“We were able to control for pregnancy complications, and found that most women with pregnancy complications known to lead to death actually deliver on weekdays, suggesting that the actual problem with weekend deliveries is even greater,” Steven L. Clark, M.D., senior author of the study explained. Researchers also looked at months of the year including “July phenomenon,” the month of the year that is associated with an increased risk of medical errors and surgical complications that occurs in association with the time of year in which United States medical school graduates begin residencies. The researchers found no association between maternal-fetal mortality and July.

Clark continued, “Any system that shows this sort of variation in the most important of all system outcomes is, by definition, badly broken. Our data suggest that a part of the overall dismal U.S. obstetric performance may be related to this systems issue, that is, there may be a ‘spill over’ effect that is demonstrably worse on weekends but is also present on weekdays to a lesser extent.  Our data does not allow us to go any further than this in terms of specifying what the problem is. However, we believe it is likely due to the fact that rarely is care of the pregnant inpatient the primary concern of the treating physician – it is almost always a distraction from office, surgery or personal activities.”

The researchers determined that by addressing this study and improving the obstetric quality of care on weekends by different methods, such as expanded use of the hospitalist or laborist model, will be one important component of addressing this issue.

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Reduction of the Most Common Cause of Maternal Death Worldwide

LAS VEGAS (Jan. 23, 2017)—In a study to be presented Friday, Jan. 27, in the oral concurrent session at 1:15 p.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™, researchers with the California Maternal Quality Care Collaborative, based at Stanford University, Palo Alto, Ca., will present  Reduction of Severe Maternal Morbidity from Hemorrhage (SMM-HEM) Using a State-Wide Perinatal Collaborative.

The California Maternal Quality Care Collaborative is comprised of multi stakeholder professional organizations (obstetricians, nurses, midwives and family practitioners), hospitals, public health department and public representatives working together to end preventable mortality and morbidity in maternity care.  The CMQCC drives improvement in maternal and infant outcomes through rapid-cycle data analytics and collaborative action.

The organization has developed a series of maternal safety toolkits aimed at responding to the leading causes of maternal morbidity and mortality including reducing complications from obstetric hemorrhage, severe hypertension and early elective delivery. The California Partnership for Maternal Safety project focused on scaling up safety initiatives to engage 126 California hospitals (with over 250,000 annual births) to improve outcomes from obstetric hemorrhage. While small studies have demonstrated the value of safety toolkits and quality improvement projects to reduce complications, this is the first project to scale to a population level showing the generalizability of this approach.

Obstetric hemorrhage is the most common cause of maternal death worldwide and the leading cause of severe maternal morbidity and preventable maternal mortality in the U.S. Among U.S. women, postpartum hemorrhage is diagnosed between 2-5% of all births with 0.5 to 1.5% considered severe (requiring transfusion or other intensive treatments.)

In this project, researchers focused on 99 hospitals that participated in the California Maternal Data Center, using rapid-cycle data that enabled access to immediate results. These hospitals had a reduction of severe hemorrhage by 21 percent after the first year of participation. Twenty-five hospitals that participated in an earlier quality collaborative and were in their second year did even better with a 28 percent reduction, illustrating that quality improvement is a continuous process.

Elliott Main, M.D. who is the medical director of the CMQCC and the presenter of the study at the SMFM annual meeting, explained, “The keys for success were (1) multi-partner engagement, (2) rapid cycle data and (3) use of a novel quality improvement model involving pairing physician and nurse mentors working with five to eight hospitals at a time, all within the construct of a large statewide project.”

Improvement was seen in all sizes and types of hospitals. Small hospitals showed the greatest improvement underscoring the quality improvement opportunities represented by their more limited resources.

State perinatal quality collaboratives are now being established in most states with the support of state departments of health, the Centers for Disease Control and Prevention, and the Maternal Child Health Bureau. California had a head start with the Perinatal/Neonatal Collaborative established in 1996 and the related Maternal Collaborative in 2006.

Main added, “The rapid-cycle California Maternal Data Center can serve as a model for using current state collected data such as birth certificates to help drive quality improvement projects and minimize data collection burden on the hospitals.”

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Study Finds Recurrent Hypertensive Disease of Pregnancy Associated with Early Mortality

LAS VEGAS (Jan. 23, 2017)—In a study to be presented Friday, Jan. 27, in the oral plenary session at 8 a.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™, researchers with University of Utah Health Sciences Center, Intermountain Healthcare and the Huntsman Cancer Institute (all in Salt Lake City, Utah), will present the study, Long-term mortality risk and life expectancy following recurrent hypertensive disease of pregnancy.

Researchers have long determined that pregnancy can provide insight into future health.  Because of the stress it puts on the body, pregnancy may unmask an underlying predisposition to health problems.

The study looked at births from 1939 to 2012 using the Utah Population Database. Using birth certificate data, researchers determined the number of pregnancies affected by hypertensive disease of pregnancy for each woman. Hypertensive disease of pregnancy is a group of diseases which includes preeclampsia, eclampsia, gestational hypertension and chronic hypertension. Primary cause of death was determined from death certificates and mortality risk by primary cause of death was compared between women with HDP and women without a history of HDP.

In the study, the researchers found that women who have two or more pregnancies complicated by hypertensive disease of pregnancy have a higher risk for early mortality from several causes compared to women who only have one affected pregnancy.

Existing recommendations for postpartum and prenatal care that may prevent recurrent hypertensive disease of pregnancy include the use of reliable contraception following delivery to prevent unintended pregnancy and taking low-dose aspirin in subsequent pregnancies to reduce recurrence risk.

Lauren Theilen, M.D. one of the primary researchers of the study and the presenter of the research at the upcoming SMFM annual meeting, explained, “Importantly, we are unable to say whether the hypertensive disease of pregnancy plays a causal role here, but we feel that further study is warranted to determine whether interventions such as early screening for chronic disease may improve long-term health outcomes among these women.”

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Skin Closure Options for Cesarean Delivery: Glue Versus Subcuticular Sutures

LAS VEGAS (Jan. 23, 2017)—In a study to be presented Thursday, Jan. 26, in the oral concurrent session at 1:15 p.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™, researchers will present their findings in a study titled, Comparison of skin closure at cesarean delivery, Glue (Dermabond) versus Intra-cuticular (Monocril) sutures: A Randomized Controlled Trial.

 Cesarean delivery rates have increased during the last few decades and it has become the most common surgery during a woman’s reproductive years. There is currently no definite evidence regarding the best method for skin closure after a cesarean surgery. Safety of the operation, healing and cosmetic outcomes are important and should influence the physician’s choice of skin closure methodology.

In this randomized controlled trial, pregnant women undergoing a scheduled cesarean delivery were randomly assigned to skin closure with glue (Dermabond) or with a monofilament synthetic suture (Monocryl). Scars were evaluated after eight weeks. Primary outcome measures were Patient and Observer Scar Assessment Scale (POSAS) scores. Secondary outcome measures were surgeon satisfaction, duration of surgery, duration of hospitalization after the cesarean delivery and complications of surgical site infection or wound complications at the incision.

“Interestingly, we compared the results immediately after the cesarean delivery and within eight weeks from surgery using a validated and reliable instrument that is practical for assessing scars—POSAS,” explained Yair Daykan, M.D., with the Dept. of Obstetrics and Gynecology at Meir Medical Center in Kfar Saba and the Sackler School of Medicine in Tel Aviv.  Dr. Daykan is also the presenter of the research at the SMFM annual meeting.

The researchers found that when both a physician, unaware of the skin closure method, and the patients themselves assessed the scar there were no significant differences found between the two groups in blood loss, infections and length of postpartum hospitalization or wound disruption. Glue and suture skin closure scores using POSAS were similar eight weeks after surgery.

“Both methods were shown to be safe and successful for skin closure after a scheduled cesarean delivery and, therefore, can be used based on the surgeon’s and patient’s preferences,” added Daykan.

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Glucose Supplementation Significantly Reduces Length of Induced Labor in Childbirth

LAS VEGAS (Jan. 23, 2017)—In a study to be presented Thursday, Jan. 26, in the oral concurrent session at 1:15 p.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™, researchers with the Université de Sherbrooke in Sherbrooke, Quebec, Canada will present their findings in a study titled, Reduction of total labor length through the addition of parenteral dextrose solution in induction of labor in nulliparous: results of DEXTRONS prospective randomized controlled trial.  The study investigated the use of glucose to shorten induced labor in nulliparous (first time giving birth). The primary outcome studied was the total length of active labor.

Prolonged labor can be harmful to maternal and fetal health. Few medical interventions are known to shorten labor duration. Because muscle performance is known to be improved by glucose supplementation, the researchers tested whether adding glucose to the intravenous hydration solution women receive during labor could accelerate labor. Two hundred pregnant women were randomly assigned to receive either a standard hydration solution containing salt and water or a solution containing glucose, salt and water.

Josianne Pare, M.D., with the Department of Obstetrics & Gynecology at the University of Sherbrooke and the presenter of the research at the SMFM annual meeting, explained, “We found that the median duration of labor was 76 minutes shorter in the group of women receiving glucose. There was no difference in the mode of delivery (cesarean section, forceps, etc.), or the neonatal well-being measures.” Pare continued, “Glucose supplementation therefore significantly reduces the total length of labor without increasing the rate of complication. This is great news for women experiencing induced labor.”

The researchers concluded that, given the low-cost and safety of this intervention, glucose should be the solute of choice during labor.

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Study Looks at a New Method for Filtering Results from Genetic Studies, Based on Inheritance Patterns Across Women of Different Racial and Ethnic Populations, in Order to Further Determine Risk of Preterm Birth

LAS VEGAS (Jan. 23, 2017)—In a study to be presented Thursday, Jan. 26, in the oral concurrent session at 1:15 p.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™, researchers verified genetic results from one large study of women with spontaneous preterm birth, and highlighted 13 key genes in both mothers and babies which may be involved in preterm birth while also identifying 123 genes as top candidates for further study.

Tracy Manuck, M.D., associate professor of Maternal Fetal Medicine and medical director of the University of North Carolina Prematurity Prevention Clinic at the University of North Carolina-Chapel Hill, is the lead researcher and presenter of the study titled Use of evolutionary triangulation to refine genetic association studies of spontaneous preterm birth (SPTB). Manuck has been working to understand which genes influence why some women deliver preterm but others do not.

Nearly half a million babies are born too soon each year in the U.S. Preterm birth (before 37 weeks of pregnancy), is the leading cause of newborn death and babies who survive an early birth often face the risk of lifetime health challenges such as breathing problems, cerebral palsy, intellectual disabilities and others. Even babies born just a few weeks early have higher rates of hospitalization and illness than full-term infants. It is a serious health problem that costs the U.S. more than $26 billion annually.

“Although many genetic studies of preterm birth have been conducted, results have been inconsistent across populations,” said Manuck. She hopes to use a new method for filtering results from genetic studies, based on inheritance patterns across women of different ancestry, in order to fine-tune results from other genetic studies of preterm birth. This technique, termed “evolutionary triangulation,” relies on the fact that the rates of preterm birth vary significantly by race. In the United States, black women are almost twice as likely to deliver preterm as white women.

In addition to highlighting 13 key genes in mothers and babies which may be involved in preterm birth, Dr. Manuck and colleagues also examined 640 genes from an online preterm birth genetic database and, using the evolutionary triangulation technique, highlighted 123 additional genes as top candidates for further study. “These results have great potential implications for future studies to identify women at highest risk for spontaneous preterm birth,” Manuck stated. “Evolutionary triangulation is an exciting new way of thinking about genetic data, and one day may be applied to other disorders of pregnancy disproportionately affecting different populations of women.”

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Study Finds that Limiting Gestational Weight Gain in Overweight and Obese Women Did Not Improve Pregnancy Complications

LAS VEGAS (Jan. 23, 2017)—In a study to be presented Thursday, Jan. 26, in the oral plenary session at 8 a.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™, researchers with Northwestern University in Chicago, Illinois, will present their findings for a study titled,  MOMFIT: A randomized clinical trial of an intervention to prevent excess gestational weight gain in overweight and obese women.

 It is now recognized that excess maternal weight gain during pregnancy is very common in the United States, and is associated with an increased risk of a number of pregnancy complications, especially in women who start pregnancy overweight or obese. These complications include gestational diabetes, maternal hypertension, excessive newborn size and cesarean delivery. Excess maternal weight gain has also been associated with higher rates of obesity in the child later in life. Some previous trials have had success with interventions to help women limit weight gain during pregnancy, but with mixed results as to whether subsequent complications were reduced.

This study performed a randomized trial with an intervention including intensive interaction with a dietician, recommendations for physical activity and internet-based self-monitoring of dietary adherence in overweight and obese women, and compared their outcomes to a similar group of women without this intervention. The intervention was successful in that average weight gain was reduced significantly, but no improvements in pregnancy outcomes were detected.

“While pregnant women should still be counseled against excess weight gain, additional measures may be required to reduce the associated complications,” stated Alan Peaceman, M.D. chief of maternal-fetal medicine in the department of obstetrics and gynecology at Northwestern Medicine in Chicago.  Peaceman will present the findings at the SMFM annual meeting.

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Study Finds Use of Fetal Genetic Sequencing Increases the Detection Rate of Genetic Findings by 10 to 30 Percent

LAS VEGAS (Jan. 23, 2017)—In a study to be presented Thursday, Jan. 26, in the oral plenary session at 8 a.m. PST, at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting™, researchers with the Columbia University Medical Center in New York found that, in preliminary data, fetal genomic (whole exome) sequencing (WES) as a diagnostic test for women with pregnancies complicated by major fetal congenital anomalies increased the detection rate of genetic findings by between 10 to 30 percent.

The study, titled Whole exome sequencing in the evaluation of fetal structural anomalies: A prospective study of sequential patients used selected patients that were felt to have a high likelihood of having a fetal genetic anomaly.

In recent years, prenatal detection of fetal congenital anomalies has become increasingly more frequent, due to the adoption of routine ultrasound imaging.  Simultaneously, advanced genetic testing has evolved demonstrating that an increasing proportion of these anomalies have a genetic cause. Approximately 10 years ago, chromosomal microarray analysis (CMA) was added to standard karyotyping as a prenatal diagnostic test increasing the detection rate of clinically significant cytogenetic abnormalities by 6% in cases with a single anomaly (abnormality) and 13% when multiple anomalies were present.  In other words, CMA looked at cell and chromosomal disorders.  These prior studies, including a multi center Eunice Kennedy Shriver National Institutes Child Health and Human Development (NICHD)-funded trial presented at a prior Society of Maternal-Fetal Medicine annual meeting, has changed national guidelines so that CMA is now the recommended test for evaluating fetal anomalies.

While CMA has been a significant improvement, an estimated 60-70% of cases with identified fetal abnormalities still remain without a genetic diagnosis.  With this current study, fetal genomic (whole exome) sequencing was evaluated as a diagnostic test for women with pregnancies complicated by major fetal congenital anomalies.

“Our preliminary data and published literature indicate that sequencing will increase the detection rate of genetic findings and this information will significantly improve patient counseling and neonatal treatment,” explained Ronald Wapner, M.D., professor of obstetrics and gynecology for the maternal fetal medicine department at Columbia University Medical Center, who is presenting the study. “New associations with genes with very specific fetal phenotypes are also beginning to be uncovered,” he added.

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