ABSTRACT
OBJECTIVE: To evaluate the effect of a "hard stop" on elective induction prior to 39 weeks at a large volume obstetrics hospital. STUDY DESIGN: From July 1, 2011, to June 30, 2013, there were 27,435 deliveries at our institution. We performed a retrospective chart review of all elective inductions I year before and after the implementation of a 39 week "hard stop" .policy. All women (n=2,574) who underwent elective induction of labor were analyzed. RESULTS: The rate of cesarean delivery was not sta- tistically different between the group evaluated before the "hard stop" and those after (20.6% vs 18%). The rate of postpartum hemorrhage decreased significantly following the policy change (6.2% vs 3.2%, respectively). There were no other clinically important differences in maternal or neonatal outcomes. CONCLUSION: The implementation of a "hard stop" policy aimed at eliminating elective inductions before 39 weeks did not affect the rate of cesarean birth.
Subject(s)
Cesarean Section/statistics & numerical data , Clinical Protocols , Labor, Induced/statistics & numerical data , Adult , Female , Gestational Age , Humans , Postpartum Hemorrhage/epidemiology , Pregnancy , Retrospective StudiesABSTRACT
In 2004, A new peculiar subtype of renal cell carcinoma, which later received the name of tubulocystic carcinoma (TCC-RC), was recognized. Though the tumor has distinct macroscopic, microscopic and immunohistochemical features, the tumor was previously considered to have some similarities to various other renal cancers. We did an extensive review of literature using PubMed and CrossRef, which yielded more than 80 cases reported from various parts of the world. We evaluated the epidemiology, tumor presentations, pathological characteristics, treatment, and outcome of TCC-RC.
Subject(s)
Carcinoma, Renal Cell/pathology , Kidney Neoplasms/pathology , HumansABSTRACT
AIM: To determine if fundal pressure at the time of cesarean delivery increases the amount of transplacental microtransfusion from mother to infant. METHODS: Pregnant women undergoing cesarean delivery were randomized to the standard uterine fundal pressure at the time of hysterotomy versus no fundal pressure. Babies of patients randomized to no fundal pressure were delivered with either vacuum or forceps. The proportion of placental alkaline phosphatase between maternal and cord blood was then determined and compared between the groups. RESULTS: Eighty-four women were randomized into two groups (44 in the pressure and 40 in the no pressure groups). There was no difference between the groups in demographic variables, or indications for cesarean. There was no difference in percentage of umbilical cord blood placental alkaline phosphatase between the pressure and no pressure groups (0.06 +/- 0.2 vs 10 +/- 0.29 IU, P = 0.43). CONCLUSIONS: Fundal pressure at the time of cesarean delivery does not increase the amount of transplacental microtransfusion, suggesting that modifying the method of cesarean would not decrease the chances of vertical transmission in HIV positive pregnant women.
