Scholars@Duke
Jerome Jeffrey Federspiel

Jerome Jeffrey Federspiel

Assistant Professor of Obstetrics and Gynecology
Obstetrics and Gynecology, Maternal Fetal Medicine
Box 3967 Med Ctr, Durham, NC 27710
2608 Erwin Road, Suite 200, Durham, NC 27705

Scholarly Works - Journal articles

Drugs to Prevent and Treat Venous Thromboembolic Disease During Pregnancy.

Journal article Clin Perinatol · September 2026 The use of agents to prevent and treat thromboembolism in pregnancy continues to increase, likely a reflection of greater burden of comorbid conditions in pregnant people, increased awareness of venous thromboembolism prevention efforts, and enhanced acces ... Full text Link to item Cite

Delays in postpartum hemorrhage interventions by race and maternal morbidity

Journal article Pregnancy · September 2026 AbstractObjectiveNon‐White patients experience higher rates of postpartum hemorrhage (PPH) as well as associated morbidity and ... Full text Cite

Maternal Intensive Care Unit Utilization by Mode of Delivery in the United States: A Retrospective Cohort Study

Journal article Anesthesia & Analgesia · August 10, 2026 BACKGROUND:Improved understanding of intensive care unit (ICU) utilization among obstetric patients is essential for optimizing outcomes, managing severe maternal morbidit ... Full text Cite

Antepartum mental health disorders and hypertensive disorders of pregnancy: a retrospective cohort study using the premier healthcare administrative database (2016-2020).

Journal article Int J Obstet Anesth · August 2026 BACKGROUND: The relationship between mental health disorders and hypertensive disorders of pregnancy is unclear. Our objective was to examine antepartum mental health disorders as risk factors for hypertensive disorders of pregnancy in a nationwide United ... Full text Link to item Cite

Transfusion and bleeding risk associated with terbutaline administration for external cephalic version among patients delivering the same day: a retrospective cohort study using the Premier Healthcare Database (2016-2020).

Journal article Int J Obstet Anesth · August 2026 INTRODUCTION: The administration of pre-procedural terbutaline is associated with increased success for external cephalic version, and its use for this purpose is supported by the American College of Obstetricians and Gynecologists. However, terbutaline's ... Full text Link to item Cite

Indications for intensive care unit transfer during delivery hospitalizations: a retrospective cohort study using the premier database (2015-2020).

Journal article Int J Obstet Anesth · August 2026 INTRODUCTION: Approximately one-quarter of intensive care unit admissions include a severe maternal morbidity event. We hypothesized that non-severe maternal morbidity intensive care unit admissions would have an increased need for intensive care unit-spec ... Full text Link to item Cite

Antenatal Anemia and Perinatal Outcomes for Patients with Cardiac Disease in Pregnancy.

Journal article Am J Perinatol · July 2026 OBJECTIVE: This study aimed to assess whether pregnant patients with antenatal anemia in the setting of cardiac disease experience an increased risk of severe maternal morbidity (SMM) and other adverse pregnancy outcomes. STUDY DESIGN: This retrospective c ... Full text Link to item Cite

Bridging the Gap Between Genetic Cardiomyopathies and Pregnancy.

Journal article JACC Adv · June 2026 Genetic testing is increasingly common for people with cardiomyopathies and arrhythmias, with cascade screening recommended for first-degree relatives of those carrying pathogenic or likely pathogenic variants. Consequently, a growing number of women of ch ... Full text Link to item Cite

Atrial Fibrillation and Atrial Flutter in Pregnancy: Epidemiology, Pathophysiology, and Management.

Journal article Obstet Gynecol Surv · June 1, 2026 IMPORTANCE: The prevalence of atrial fibrillation (AF) and atrial flutter (AFL) among pregnant patients has increased over time, with AF now being the most common sustained cardiac arrhythmia in pregnancy. Management of AF/AFL in pregnancy presents unique ... Full text Link to item Cite

The association between postpartum aspirin use and NT-proBNP levels as a marker for maternal cardiac health: a randomized controlled trial.

Journal article Am J Obstet Gynecol · May 2026 BACKGROUND: During pregnancy, administration of low-dose aspirin 81 mg (LDA) has been demonstrated to decrease the incidence of preeclampsia in at-risk individuals. However, the role of continuation of LDA in the postpartum period and its association with ... Full text Link to item Cite

Prophylactic-Dose Rivaroxaban Transfer Into Human Milk.

Journal article Obstet Gynecol · May 1, 2026 Direct oral anticoagulants are increasingly used for postoperative thromboprophylaxis, but use is limited in postpartum populations in the absence of data informing transfer into human milk. We evaluated the excretion of prophylactic-dose rivaroxaban into ... Full text Link to item Cite

Serum BAFF levels in pregnant patients with systemic lupus erythematosus.

Journal article Lupus · April 2026 Background/PurposeThe B cell Activating Factor (BAFF) signaling pathway influences rheumatic disease through its role in the selection, maturation, and survival of B cells. Increased BAFF also correlates with hypertension and preeclampsia in pregnant women ... Full text Link to item Cite

Pregnancy outcomes among medically complex populations with high risk of pregnancy mortality in Virginia: a retrospective observational study.

Journal article BMC Med · February 18, 2026 BACKGROUND: Abortion may be medically indicated to avert death or permanent harm of the pregnant person. However, some US states now prevent access to abortion for these patients. To evaluate the population for whom this may cause harm, we aimed to estimat ... Full text Link to item Cite

Brain Natriuretic Peptide Screening in Pregnancy and Association with Severe Maternal Morbidity during Delivery Hospitalization.

Journal article Am J Perinatol · February 16, 2026 This study aimed to describe patterns of outpatient natriuretic peptide (NP) testing and levels, including brain NP (BNP) and N-terminal pro-BNP (NT-proBNP), among pregnant patients with and without heart disease (HD) and the association between NP and sev ... Full text Link to item Cite

Postpartum Readmission for Pregnancy-Associated Thrombotic Microangiopathy Is Associated With Poor Maternal Outcomes.

Journal article J Clin Apher · February 2026 The postpartum period represents a high-risk interval for presentation with a pregnancy-associated thrombotic microangiopathy (TMA). Given the possibility of immune thrombotic thrombocytopenic purpura, postpartum TMA is typically treated with initiation of ... Full text Link to item Cite

Postoperative venous thromboembolism following cesarean delivery: prevalence, pathophysiology, diagnosis, treatment, and prevention.

Journal article Am J Obstet Gynecol · January 2026 Venous thromboembolism contributes to approximately 10% of pregnancy-associated deaths in the United States, with the highest incidence rate in the immediate postpartum period. Cesarean deliveries are associated with 4-fold relative risk of venous thromboe ... Full text Link to item Cite

Hypertensive Disorders of Pregnancy in Patients With Cardiac Disease: Risk and Impact on Delivery Timing.

Journal article JACC Adv · October 2025 BACKGROUND: Pregnant patients with cardiovascular disease (CVD) face increased risk of hypertensive disorders of pregnancy (HDP) and preterm delivery, yet data are limited regarding the degree of risk and impact of HDP on gestational age at delivery. OBJEC ... Full text Link to item Cite

Postpartum thromboembolism risk by CHA 2 DS 2 ‐VASc score in patients with atrial fibrillation or flutter during pregnancy

Journal article Pregnancy · September 2025 AbstractIntroduction To evaluate whether rates of postpartum thromboembolism (TE), transient ischemic att ... Full text Cite

Development and Validation of a Predictive Model for Maternal Cardiovascular Morbidity Events in Patients With Hypertensive Disorders of Pregnancy.

Journal article Anesth Analg · August 1, 2025 BACKGROUND: Hypertensive disorders of pregnancy (HDP) are a major contributor to maternal morbidity, mortality, and accelerated cardiovascular (CV) disease. Comorbid conditions are likely important predictors of CV risk in pregnant people. Currently, there ... Full text Link to item Cite

Indomethacin and Cefazolin for Physical Exam-Indicated Cerclage to Improve Latency: A Protocol Validation Study.

Journal article Am J Perinatol · August 2025 A single-center randomized trial showed improved latency with use of indomethacin and cefazolin (I/C) during and following exam-indicated cerclage (EIC). The same center recently published a pre/post comparison demonstrating similar results. This research ... Full text Link to item Cite

Moving the ACR's Reproductive Health Guidelines Into Practice: A Quantitative and Qualitative Assessment of a Novel Reproductive Rheumatology ECHO.

Journal article J Clin Rheumatol · August 1, 2025 BACKGROUND: Project ECHO (Extension for Community Healthcare Outcomes) links experts with community providers through video teleconferences that include both didactics and case discussions. We piloted the first ECHO with a specific focus on reproductive rh ... Full text Link to item Cite

Pregnancy and Delivery Care for a Patient With a HeartMate 3.

Journal article JACC Case Rep · June 4, 2025 BACKGROUND: The limited available data on pregnancies among patients with left ventricular assist devices (LVADs) in situ shows elevated rates of maternal and fetal/neonatal morbidity and mortality. The first fully magnetically levitated device providing c ... Full text Open Access Link to item Cite

Rhesus D Prophylaxis: When and Why We Give Rhesus D Immunoglobulin.

Journal article Obstet Gynecol Surv · May 2025 IMPORTANCE: Hemolytic disease of the fetus and newborn (HDFN) is caused by maternal alloantibodies to fetal red blood cells and is associated with significant fetal and neonatal morbidity and mortality. Rhesus D antigen (RhD)-mediated HDFN is the only prev ... Full text Link to item Cite

Hereditary Hemorrhagic Telangiectasia: Pregnancy and Delivery-Specific Considerations and Outcomes

Journal article American Journal of Perinatology · April 2025 AbstractPrior studies have evaluated maternal outcomes in patients with hereditary hemorrhagic telangiectasia (HHT), yet pregnancy- and delivery-specific data remain limited. This study aims to evaluate pregnancy and delive ... Full text Cite

The Utility of a Critical Antibody Titer in Anti-K Alloimmunized Pregnancies: A Systematic Review and Meta-Analysis of Diagnostic Test Accuracy.

Journal article Transfus Med Rev · April 2025 Anti-Kell (anti-K) alloimmunization is a known cause of severe hemolytic disease of the fetus and newborn (HDFN), yet the utility of a critical maternal antibody titer in guiding clinical management remains debated. We conducted a systematic review and met ... Full text Link to item Cite

Inpatient pharmacological thromboprophylaxis in the antepartum period: an argument for risk-based thromboprophylaxis.

Journal article Am J Obstet Gynecol MFM · March 2025 Venous thromboembolism (VTE) is a significant cause of maternal morbidity and mortality in the United States. People hospitalized during pregnancy for reasons other than routine birth (ie, during antepartum admissions) are at increased risk of VTE compared ... Full text Link to item Cite

Low-dose aspirin versus placebo in postpartum venous thromboembolism: a multi-national, pilot, randomised, placebo-controlled trial.

Journal article Lancet Haematol · February 2025 BACKGROUND: Despite the morbidity and mortality of venous thromboembolism, there is little evidence to guide postpartum thromboprophylaxis in patients at moderate risk. We aimed to assess the feasibility of conducting a double-blind, randomised trial of as ... Full text Link to item Cite

Temporal changes in hospital readmissions for postpartum hypertension in the US, 2010 to 2019; a serial cross-sectional analysis.

Journal article PLoS One · 2025 BACKGROUND: Hypertension is the most common primary diagnosis associated with postpartum readmissions within 42 days of delivery hospitalization. In the United States, nearly half of the cases of eclampsia, a severe form of preeclampsia, develop during the ... Full text Link to item Cite

Racial, Ethnic, and Color-Based Discrimination and Pre-Pregnancy Risk Factors for Preeclampsia Among Nulliparous Patients.

Journal article Health Equity · 2025 INTRODUCTION: Obesity and chronic hypertension are well-known risk factors for maternal morbidity and mortality. Evidence suggests racism contributes to the development of these chronic conditions. METHODS: We conducted a secondary analysis of the Nullipar ... Full text Link to item Cite

The association of insertion methods on immediate postpartum intrauterine device expulsion rates: A retrospective cohort study.

Journal article Contraception · November 2024 OBJECTIVE: To evaluate the method of immediate postpartum IUD (ppIUD) insertion (manual versus ring forceps) and expulsion rate within 6-week postpartum. STUDY DESIGN: We performed a retrospective cohort study of patients who had a singleton vaginal delive ... Full text Link to item Cite

Maternal morbidity in postpartum severe preeclampsia by obstetric delivery volume

Journal article American Journal of Obstetrics & Gynecology MFM · November 2024 Full text Cite

Standard Compared With Extended Red Blood Cell Antigen Matching for Prevention of Subsequent Hemolytic Disease of the Fetus and Newborn: A Systematic Review.

Journal article Obstet Gynecol · October 1, 2024 OBJECTIVE: To systematically review and meta-analyze alloimmunization among recipients of red blood cells (RBCs) matched for ABO blood type and Rhesus D (ABO+D) antigen compared with those also matched for c, E, and Kell (cEK). DATA SOURCES: Four online da ... Full text Link to item Cite

Antithrombin testing and treatment in pregnancy: Their real-world relationship to clinical outcomes.

Journal article Thromb Res · September 2024 BACKGROUND: Antithrombin (AT) deficiency is a severe thrombophilia associated with increased rates of maternal morbidity, mortality, and greater healthcare resource utilization during pregnancy and postpartum. METHODS: Two large U.S. healthcare databases w ... Full text Link to item Cite

Maternal red blood cell alloimmunization prevalence in the United States.

Journal article Blood Adv · August 27, 2024 Hemolytic disease of fetus and newborn (HDFN) is a life-threatening disease mediated by maternal alloimmunization to red blood cell (RBC) antigens. Studies of maternal alloimmunization prevalence in the United States lack national data. This study describe ... Full text Link to item Cite

Pregnancy-Associated Extracorporeal Membrane Oxygenation in the United States.

Journal article Am J Perinatol · May 2024 OBJECTIVE: The use of extracorporeal membrane oxygenation (ECMO) therapy has increased in the adult population. Studies from the H1N1 influenza pandemic suggest that ECMO deployment in pregnancy is associated with favorable outcomes. With increasing number ... Full text Link to item Cite

Maternal Morbidity According to Mode of Delivery Among Pregnant Patients With Pulmonary Hypertension.

Journal article Anesth Analg · May 1, 2024 BACKGROUND: Patients with pulmonary hypertension have a high risk of maternal morbidity and mortality. It is unknown if a trial of labor carries a lower risk of morbidity in these patients compared to a planned cesarean delivery. The objective of this stud ... Full text Link to item Cite

Associations between Anemia and Outcomes of Pregnant Patients with Pyelonephritis.

Journal article Am J Perinatol · May 2024 OBJECTIVE: This study aims to determine if pregnant patients with both pyelonephritis and anemia are at an increased risk of adverse maternal outcomes compared with those with pyelonephritis without anemia. STUDY DESIGN: We conducted a retrospective cohort ... Full text Link to item Cite

Validation of Three Models for Prediction of Blood Transfusion during Cesarean Delivery Admission.

Journal article Am J Perinatol · May 2024 OBJECTIVE: Prediction of blood transfusion during delivery admission allows for clinical preparedness and risk mitigation. Although prediction models have been developed and adopted into practice, their external validation is limited. We aimed to evaluate ... Full text Link to item Cite

Hospital Discharge Codes and Overestimating Severe Maternal Morbidity During Delivery Hospitalization.

Journal article Obstet Gynecol · April 1, 2024 Our objective was to identify birth hospitalization severe maternal morbidity (SMM) diagnoses that were also coded during prior encounters and, thus, potentially falsely carried forward as de novo SMM events. This retrospective cohort study included pregna ... Full text Link to item Cite

Machine Learning Models for Prediction of Maternal Hemorrhage and Transfusion: Model Development Study.

Journal article JMIR Bioinform Biotechnol · February 5, 2024 BACKGROUND: Current postpartum hemorrhage (PPH) risk stratification is based on traditional statistical models or expert opinion. Machine learning could optimize PPH prediction by allowing for more complex modeling. OBJECTIVE: We sought to improve PPH pred ... Full text Link to item Cite

Postpartum Pyelonephritis and Risk of Severe Maternal Morbidity.

Journal article Am J Perinatol · February 2024 OBJECTIVE: Pyelonephritis is the most common nonobstetric cause for hospitalization during pregnancy. The maternal and obstetric complications associated with antepartum pyelonephritis are well described. However, it is not clear whether these risks extend ... Full text Link to item Cite

Racial and ethnic disparities in eligibility for postpartum venous thromboembolism prophylaxis in the United States.

Journal article J Thromb Haemost · February 2024 BACKGROUND: Postpartum venous thromboembolism (VTE) incidence differs by race and ethnicity in the United States. However, it is unclear whether the eligibility criteria for postpartum VTE prophylaxis mirror this disparity. OBJECTIVE: To characterize the p ... Full text Link to item Cite

Induced Abortion for Maternal Cardiac Indication: 2 Cases of Unintended Pregnancy With LVAD.

Journal article JACC Case Rep · December 6, 2023 We present 2 cases of patients with left ventricular assist device who underwent an induced abortion in the first and second trimester, respectively. Comprehensive counseling is critical for this patient population, and close coordination of interdisciplin ... Full text Link to item Cite

Maternal and Pregnancy Outcomes Following Heart Transplantation in the United States.

Journal article JACC Heart Fail · December 2023 BACKGROUND: Improved survival following heart transplantation (HT) has led to more recipients contemplating pregnancy, but data on outcomes are limited. OBJECTIVES: The authors used a national data set to investigate and describe outcomes of pregnancies an ... Full text Link to item Cite

Projected impact of guidelines on incidence of venous thromboembolism after cesarean delivery in the United States.

Journal article J Thromb Haemost · December 2023 BACKGROUND: There is large variation in recommended for postcesarean delivery venous thromboembolism (VTE) prophylaxis among commonly used guidelines. OBJECTIVES: The aim of the study is to estimate implications of adoption of VTE prevention guidelines for ... Full text Link to item Cite

Severe Maternal Morbidity According to Mode of Delivery Among Pregnant Patients With Cardiomyopathies.

Journal article JACC Heart Fail · December 2023 BACKGROUND: Women with cardiomyopathies are at risk for pregnancy complications. The optimal mode of delivery in these patients is guided by expert opinion and limited small studies. OBJECTIVES: The objective of this study is to examine the association of ... Full text Link to item Cite

Risk of stillbirth in United States patients with diagnosed intrahepatic cholestasis of pregnancy.

Journal article Am J Obstet Gynecol · October 2023 BACKGROUND: Intrahepatic cholestasis of pregnancy is associated with a 4- to 10-fold increase in the risk of stillbirth in the absence of intervention, leading to recommendations for antenatal assessment, ursodiol use, and often preterm or early term deliv ... Full text Link to item Cite

High rates of venous thromboembolism among deliveries complicated by cancer.

Journal article J Thromb Haemost · October 2023 BACKGROUND: Venous thromboembolism (VTE) risk is increased independently by both cancer and pregnancy. OBJECTIVES: To estimate VTE risk in the postpartum period among patients delivering with a cancer diagnosis, stratified by cancer type and delivery route ... Full text Link to item Cite

Maternal morbidity in pregnancies affected by anencephaly.

Journal article Am J Obstet Gynecol · September 2023 Using national birth-registry data, composite maternal morbidity is increased in pregnancies affected by anencephaly when compared to unaffected pregnancies. ... Full text Link to item Cite

Maternal morbidity and mortality among patients with cancer at time of delivery.

Journal article Am J Obstet Gynecol · September 2023 BACKGROUND: Individuals with cancer during pregnancy are a medically complex patient population that is anticipated to grow. A better understanding of this population and patterns of risk at time of delivery would offer an opportunity for providers to miti ... Full text Link to item Cite

Validation of a sonographic checklist for the detection of histologic placenta accreta spectrum.

Journal article Am J Obstet Gynecol MFM · August 2023 BACKGROUND: To standardize research terminology and to reduce unanticipated placenta accreta spectrum, the European Working Group for Abnormally Invasive Placenta developed a consensus checklist for reporting suspected placenta accreta spectrum observed du ... Full text Link to item Cite

Racial and Rural-Urban Disparities in Maternal Cardiac Disease Care in North Carolina: A Call to Action

Journal article North Carolina Medical Journal · July 5, 2023 BackgroundCardiac disease is a leading cause of severe maternal morbidity (SMM). We sought to estimate the effects of race and rural-urban status on cardia ... Full text Cite

Mode of delivery among women with maternal cardiac disease.

Journal article J Perinatol · July 2023 OBJECTIVE: To determine if maternal cardiac disease affects delivery mode and to investigate maternal morbidity. STUDY DESIGN: Retrospective cohort study performed using electronic medical record data. Primary outcome was mode of delivery; secondary outcom ... Full text Link to item Cite

Multidisciplinary care of the pregnant patient with or at risk for venous thromboembolism: a recommended toolkit from the Foundation for Women and Girls with Blood Disorders Thrombosis Subcommittee.

Journal article J Thromb Haemost · June 2023 The care of pregnant persons with/at risk of venous thromboembolism is complex and often challenging. Although guidelines have been published regarding the use of specific therapies, such as anticoagulants; in this population, none have provided guidance o ... Full text Link to item Cite

Maternal Cardiovascular Morbidity Events Following Preeclampsia: A Retrospective Cohort Study.

Journal article Anesth Analg · April 1, 2023 BACKGROUND: Patients with preeclampsia are at high risk for long-term cardiovascular events, yet the short-term, acute cardiovascular complications that follow preeclampsia are understudied. The objective of this study was to compare the short-term, acute ... Full text Link to item Cite

Novel Antithrombotic Agents in Pregnancy Anticoagulants and Antiplatelet Agents.

Journal article Clin Obstet Gynecol · March 1, 2023 Increasing rates of thromboembolic complications have required increasing use of anticoagulant and antiplatelet agents during and after pregnancy. Furthermore, thromboembolism is both a cause and a complication of severe maternal morbidity requiring intens ... Full text Link to item Cite

Preventing postpartum hemorrhage with combined therapy rather than oxytocin alone.

Journal article Am J Obstet Gynecol MFM · February 2023 Postpartum hemorrhage is the leading cause of maternal morbidity and mortality worldwide, with uterine atony estimated to account for 70% to 80% of cases, thereby remaining the single most common cause. Pharmacotherapy remains the first-line preventative t ... Full text Link to item Cite

Postpartum hemorrhage protocols and benchmarks: improving care through standardization.

Journal article Am J Obstet Gynecol MFM · February 2023 Postpartum hemorrhage remains a leading cause of maternal morbidity and mortality in the United States. Several state maternal morbidity and mortality committees have reviewed areas of opportunity concerning postpartum hemorrhage management and found that ... Full text Link to item Cite

For better care we need better data: towards a national obstetrics registry.

Journal article Am J Obstet Gynecol MFM · January 2023 Unacceptably high rates of severe maternal morbidity and mortality in the United States and stark racial disparities in outcomes are generating efforts to improve both research capacity and quality improvement in obstetrical care. Comprehensive, high-quali ... Full text Link to item Cite

Maternal and neonatal outcomes in patients with hepatitis C and intrahepatic cholestasis of pregnancy: The sum of the parts.

Journal article PLoS One · 2023 OBJECTIVE: Hepatitis C virus and intrahepatic cholestasis of pregnancy (ICP) are well-known independent risk factors for adverse outcomes in pregnancy. In addition, it is well-established that there is an association between Hepatitis C and ICP. This study ... Full text Link to item Cite

Maternal and obstetric outcomes of listeria pregnancy: insights from a national cohort.

Journal article J Matern Fetal Neonatal Med · December 2022 OBJECTIVE: We sought to evaluate and describe the maternal and obstetric morbidity associated with Listeria infection in pregnancy. METHODS: Retrospective cohort of pregnant women using the 2007-2018 National Inpatient Sample. Pregnant women with discharge ... Full text Link to item Cite

Impact of Pre-Existing Ischemic Heart Disease on Severe Maternal Morbidity and Mortality During Delivery Hospitalizations.

Journal article JACC Adv · December 2022 BACKGROUND: The impact of pre-existing ischemic heart disease (IHD) on pregnancy is incompletely described. OBJECTIVES: The purpose of this study was to compare adverse pregnancy outcomes between those with IHD and those with a cardiac diagnosis categorize ... Full text Link to item Cite

Comparison of severe maternal morbidity in pregnancy by modified World Health Organization Classification of maternal cardiovascular risk.

Journal article Am Heart J · August 2022 BACKGROUND: To compare rates of severe maternal morbidity (SMM) for pregnant patients with a cardiac diagnosis classified by the modified World Health Organization (mWHO) classification to those without a cardiac diagnosis. METHODS: This retrospective stud ... Full text Link to item Cite

Morbidity of late-season influenza during pregnancy.

Journal article Am J Obstet Gynecol MFM · January 2022 BACKGROUND: In the Northern Hemisphere, influenza season typically starts in December and lasts through March. Pregnant people are at increased risk for influenza-related morbidity and mortality. Potentially, new viral strains or reduced provider suspicion ... Full text Link to item Cite

Disparities in obstetric hemorrhage outcomes.

Journal article Res Pract Thromb Haemost · January 2022 Both the maternal and fetal outcomes of pregnancy vary greatly according to a pregnant woman's community and her condition. The most devastating outcome is the death of a mother. In 2017, there were ≈295,000 maternal deaths globally with dramatic differenc ... Full text Link to item Cite

Maternal and Fetal Outcomes Associated With Infective Endocarditis in Pregnancy.

Journal article Clin Infect Dis · November 2, 2021 BACKGROUND: Infective endocarditis (IE) is a rare but serious infection that complicates pregnancy. Little is known about IE management and outcomes in this population. METHODS: The National Readmissions Database was used to obtain data between October 201 ... Full text Open Access Link to item Cite

Infective endocarditis and solid organ transplantation: Only worse outcomes during initial transplantation hospitalization.

Journal article Am Heart J · October 2021 BACKGROUND: The epidemiology, and outcome of infective endocarditis (IE) among solid organ transplant (SOT) recipients is unknown. METHODS: We used data from the 2013-2018 Nationwide Readmissions Database (NRD). IE- and SOT-associated hospitalizations were ... Full text Open Access Link to item Cite

ACC-AHA Diagnostic Criteria for Hypertension in Pregnancy Identifies Patients at Intermediate Risk of Adverse Outcomes.

Journal article Am J Perinatol · August 2021 OBJECTIVE: The aim of the study is to compare maternal and neonatal outcomes among patients who are normotensive, hypertensive by Stage I American College of Cardiology-American Heart Association (ACC-AHA) criteria, and hypertensive by American College of ... Full text Link to item Cite

Venous thromboembolism incidence among patients recommended for pharmacologic thromboembolism prophylaxis after cesarean delivery in selected guidelines.

Journal article J Thromb Haemost · March 2021 BACKGROUND: Multiple guidelines regarding risk stratification for venous thromboembolism (VTE) incidence following cesarean delivery have been promulgated. OBJECTIVE: To estimate the percentage of cesarean delivery patients for which pharmacologic VTE woul ... Full text Link to item Cite

Interactions between highly active antiretroviral therapy and over-the-counter agents: a cautionary note.

Journal article BMJ Case Rep · January 6, 2021 Highly active antiretroviral therapy (HAART) has dramatically lowered rates of mother-to-child HIV transmission among patients with access to treatment. Barriers to complete viral suppression increase rates of transmission, even with only low levels of vir ... Full text Link to item Cite

Hospitalization Duration Following Uncomplicated Cesarean Delivery: Predictors, Facility Variation, and Outcomes.

Journal article AJP Rep · April 2020 Objectives  This study was designed to: (1) characterize stay duration following cesarean delivery, (2) ascertain whether facility variation exists, and (3) determine whether shorter stays are associated with rates of readmission or costs. Study Design  Th ... Full text Link to item Cite

Intravenous Tissue Plasminogen Activator in Stroke Mimics.

Journal article Circ Cardiovasc Qual Outcomes · August 2019 BACKGROUND: The necessity for rapid evaluation and treatment of acute ischemic stroke with intravenous tPA (tissue-type plasminogen activator) may increase the risk of administrating tPA to patients presenting with noncerebrovascular conditions that closel ... Full text Link to item Cite

Intravenous tPA (Tissue-Type Plasminogen Activator) in Patients With Acute Ischemic Stroke Taking Non-Vitamin K Antagonist Oral Anticoagulants Preceding Stroke.

Journal article Stroke · September 2018 Background and Purpose- Although there are no trials or large cohorts to inform clinical care, current guidelines caution against giving intravenous tPA (tissue-type plasminogen activator) to patients with acute ischemic stroke who are taking non-vitamin K ... Full text Link to item Cite

Antihypertensive adherence and outcomes among community-dwelling Medicare beneficiaries: the Atherosclerosis Risk in Communities Study.

Journal article J Eval Clin Pract · February 2018 RATIONALE, AIMS, AND OBJECTIVES: Despite proven benefits for reducing incidence of major cardiac events, antihypertensive drug therapy remains underutilized in the United States. This analysis assesses antihypertensive drug adherence, utilization predictor ... Full text Link to item Cite

Solitary fibrous tumor of the vulva resulting in spinal metastasis: A case report.

Journal article Gynecol Oncol Rep · November 2017 •Solitary fibrous tumors are typically indolent tumors of the pleura.•Primary origin in the female reproductive organs is rare, as are aggressive forms.•We report a case of a vulvar solitary fibrous tumor, notable for extensive spinal metastasis. ... Full text Link to item Cite

Unexplained Variation for Hospitals' Use of Inpatient Rehabilitation and Skilled Nursing Facilities After an Acute Ischemic Stroke.

Journal article Stroke · October 2017 BACKGROUND AND PURPOSE: Rehabilitation is recommended after a stroke to enhance recovery and improve outcomes, but hospital's use of inpatient rehabilitation facilities (IRFs) or skilled nursing facility (SNF) and the factors associated with referral are u ... Full text Link to item Cite

Use of Intravenous Recombinant Tissue Plasminogen Activator in Patients With Acute Ischemic Stroke Who Take Non-Vitamin K Antagonist Oral Anticoagulants Before Stroke.

Journal article Circulation · March 14, 2017 BACKGROUND: Intravenous rt-PA (recombinant tissue-type plasminogen activator) is effective in improving outcomes in ischemic stroke; however, there are few data on the use of rt-PA in patients who are receiving a non-vitamin K antagonist oral anticoagulant ... Full text Link to item Cite

Comparing Inverse Probability of Treatment Weighting and Instrumental Variable Methods for the Evaluation of Adenosine Diphosphate Receptor Inhibitors After Percutaneous Coronary Intervention.

Journal article JAMA Cardiol · September 1, 2016 IMPORTANCE: There is increasing interest in performing comparative effectiveness analyses in large observational databases, yet these analyses must adjust for treatment selection issues. OBJECTIVES: To conduct comparative safety and efficacy analyses of pr ... Full text Open Access Link to item Cite

Endoscopic Resection of Sinonasal Malignancy: A Systematic Review and Meta-analysis.

Journal article Otolaryngol Head Neck Surg · September 2016 OBJECTIVES: The use of endoscopic approaches for sinonasal malignancy resection has increased, but survival data are limited secondary to disease rarity and new surgical technique. Here we present a systematic review and meta-analysis of endoscopic endonas ... Full text Link to item Cite

Economic Outcomes With Anatomical Versus Functional Diagnostic Testing for Coronary Artery Disease.

Journal article Ann Intern Med · July 19, 2016 BACKGROUND: PROMISE (PROspective Multicenter Imaging Study for Evaluation of Chest Pain) found that initial use of at least 64-slice multidetector computed tomography angiography (CTA) versus functional diagnostic testing strategies did not improve clinica ... Full text Open Access Link to item Cite

History of AIDS in HIV-Infected Patients Is Associated With Higher In-Hospital Mortality Following Admission for Acute Myocardial Infarction and Stroke.

Journal article J Infect Dis · June 15, 2016 BACKGROUND: Although human immunodeficiency virus (HIV)-infected persons are at increased risk for major cardiovascular events, short-term prognosis after these events is unclear. METHODS: To determine the association between HIV infection and acute myocar ... Full text Link to item Cite

Risks and Benefits Associated With Prestroke Antiplatelet Therapy Among Patients With Acute Ischemic Stroke Treated With Intravenous Tissue Plasminogen Activator.

Journal article JAMA Neurol · January 2016 IMPORTANCE: Intravenous tissue plasminogen activator (tPA) is known to improve outcomes in ischemic stroke; however, many patients may have been receiving antiplatelet therapy before acute ischemic stroke and could face an increased risk for bleeding when ... Full text Open Access Link to item Cite

Association of inpatient vs outpatient onset of ST-elevation myocardial infarction with treatment and clinical outcomes.

Journal article JAMA · November 19, 2014 IMPORTANCE: Reperfusion times for ST-elevation myocardial infarction (STEMI) occurring in outpatients have improved significantly, but quality improvement efforts have largely ignored STEMI occurring in hospitalized patients (inpatient-onset STEMI). OBJECT ... Full text Link to item Cite

Examination of the treatment selection process in a multicenter observational study.

Journal article Circ Cardiovasc Qual Outcomes · September 2014 BACKGROUND: Many multicenter clinical trials use permuted-block randomization to create balanced treatment allocations within clinical centers. Unlike randomized trials, observational studies do not control treatment allocation, and statistical models are ... Full text Link to item Cite

Clinical implications of referral bias in the diagnostic performance of exercise testing for coronary artery disease.

Journal article J Am Heart Assoc · December 13, 2013 BACKGROUND: Exercise testing with echocardiography or myocardial perfusion imaging is widely used to risk-stratify patients with suspected coronary artery disease. However, reports of diagnostic performance rarely adjust for referral bias, and this practic ... Full text Link to item Cite

Impact of choice of imaging modality accompanying outpatient exercise stress testing on outcomes and resource use after revascularization for acute coronary syndromes.

Journal article Am Heart J · October 2013 BACKGROUND: Exercise stress testing is commonly obtained after percutaneous coronary intervention (PCI) performed for acute coronary syndromes (ACS). We compared the relationships between exercise echocardiography and nuclear testing after ACS-related PCI ... Full text Link to item Cite

Use of stress testing and diagnostic catheterization after coronary stenting: association of site-level patterns with patient characteristics and outcomes in 247,052 Medicare beneficiaries.

Journal article J Am Coll Cardiol · July 30, 2013 OBJECTIVES: The aim of this study was to determine diagnostic testing patterns after percutaneous coronary intervention (PCI). BACKGROUND: Little is known about patterns of diagnostic testing after PCI in the United States or the relationship of these patt ... Full text Link to item Cite

Disappearing and reappearing differences in drug-eluting stent use by race.

Journal article J Eval Clin Pract · April 2013 RATIONALE, AIMS AND OBJECTIVES: Drug-eluting coronary stents (DES) rapidly dominated the marketplace in the United States after approval in 2003, but utilization rates were initially lower among African American patients. We assess whether racial differenc ... Full text Link to item Cite

Resource use trajectories for aged medicare beneficiaries with complex coronary conditions.

Journal article Health Serv Res · April 2013 OBJECTIVE: To use coronary revascularization choice to illustrate the application of a method simulating a treatment's effect on subsequent resource use. DATA SOURCES: Medicare inpatient and outpatient claims from 2002 to 2008 for patients receiving multiv ... Full text Link to item Cite

Patterns of stress testing and diagnostic catheterization after coronary stenting in 250 350 medicare beneficiaries.

Journal article Circ Cardiovasc Imaging · January 1, 2013 BACKGROUND: Patterns of noninvasive stress test (ST) and invasive coronary angiography (CA) utilization after percutaneous coronary intervention (PCI) are not well described in older populations. METHODS AND RESULTS: We linked National Cardiovascular Data ... Full text Link to item Cite

Stress imaging use and repeat revascularization among medicare patients with high-risk coronary artery disease.

Journal article Am J Cardiol · November 1, 2012 The optimal use of stress testing after coronary revascularization remains unclear, and overuse of stress testing might increase the rates of repeat revascularization. We analyzed the association at both the patient and regional level between the use of st ... Full text Link to item Cite

Patterns and predictors of stress testing modality after percutaneous coronary stenting: data from the NCDR(®).

Journal article JACC Cardiovasc Imaging · October 2012 OBJECTIVES: We evaluated temporal trends and geographic variation in choice of stress testing modality after percutaneous coronary intervention (PCI), as well as associations between modality and procedure use after testing. BACKGROUND: Stress testing is f ... Full text Link to item Cite

Downstream testing and subsequent procedures after coronary computed tomographic angiography following coronary stenting in patients ≥65 years of age.

Journal article Am J Cardiol · September 15, 2012 Limited data are available on the use of coronary computed tomographic angiography (CCTA) in patients who have received percutaneous coronary intervention (PCI). To evaluate patterns of cardiac testing including CCTA after PCI, we created a retrospective o ... Full text Link to item Cite

Evaluating the effectiveness of a rapidly adopted cardiovascular technology with administrative data: the case of drug-eluting stents for acute coronary syndromes.

Journal article Am Heart J · August 2012 BACKGROUND: Instrumental variable (IV) methods can correct for unmeasured confounding when using administrative (claims) data for cardiovascular outcomes research, but difficulties identifying valid IVs have limited their use. We evaluated the safety and e ... Full text Link to item Cite

Ticagrelor versus genotype-driven antiplatelet therapy for secondary prevention after acute coronary syndrome: a cost-effectiveness analysis.

Journal article Value Health · June 2011 BACKGROUND: Clopidogrel's effectiveness is likely reduced significantly for prevention of thrombotic events after acute coronary syndrome (ACS) in patients exhibiting a decreased ability to metabolize clopidogrel into its active form. A genetic mutation re ... Full text Link to item Cite

Risk-benefit trade-offs in revascularisation choices.

Journal article EuroIntervention · March 2011 AIMS: When patients choose percutaneous coronary intervention (PCI) over coronary artery bypass grafting (CABG), they accept an increased long-term risk of repeat revascularisation in exchange for short-term morbidity benefits. This paper quantifies the ri ... Full text Link to item Cite

Three-year outcomes of multivessel revascularization in very elderly acute coronary syndrome patients.

Journal article Ann Thorac Surg · June 2010 BACKGROUND: Comparative effectiveness of interventional treatment strategies for the very elderly with acute coronary syndrome remains poorly defined due to study exclusions. Interventions include percutaneous coronary intervention (PCI), usually with sten ... Full text Link to item Cite

Heterogeneous vancomycin-intermediate susceptibility phenotype in bloodstream methicillin-resistant Staphylococcus aureus isolates from an international cohort of patients with infective endocarditis: prevalence, genotype, and clinical significance.

Journal article J Infect Dis · November 1, 2009 BACKGROUND: The significance of heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) is unknown. Using a multinational collection of isolates from methicillin-resistant S. aureus (MRSA) infective endocarditis (IE), we characterized patients ... Full text Link to item Cite

Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study.

Journal article Arch Intern Med · March 9, 2009 BACKGROUND: We sought to provide a contemporary picture of the presentation, etiology, and outcome of infective endocarditis (IE) in a large patient cohort from multiple locations worldwide. METHODS: Prospective cohort study of 2781 adults with definite IE ... Full text Link to item Cite

Associations between the genotypes of Staphylococcus aureus bloodstream isolates and clinical characteristics and outcomes of bacteremic patients.

Journal article J Clin Microbiol · September 2008 We investigated associations between the genotypic and phenotypic features of Staphylococcus aureus bloodstream isolates and the clinical characteristics of bacteremic patients enrolled in a phase III trial of S. aureus bacteremia and endocarditis. Isolate ... Full text Link to item Cite

Genotypic diversity of coagulase-negative staphylococci causing endocarditis: a global perspective.

Journal article J Clin Microbiol · May 2008 Coagulase-negative staphylococci (CNS) are important causes of infective endocarditis (IE), but their microbiological profiles are poorly described. We performed DNA target sequencing and susceptibility testing for 91 patients with definite CNS IE who were ... Full text Link to item Cite

Genotypic characteristics of Staphylococcus aureus isolates from a multinational trial of complicated skin and skin structure infections.

Journal article J Clin Microbiol · February 2008 The impact of bacterial genetic characteristics on the outcome of patients with Staphylococcus aureus infections is uncertain. This investigation evaluated potential associations between bacterial genotype and clinical outcome using isolates collected as p ... Full text Link to item Cite

Emergence of coagulase-negative staphylococci as a cause of native valve endocarditis.

Journal article Clin Infect Dis · January 15, 2008 BACKGROUND: Coagulase-negative staphylococci (CoNS) are an infrequent cause of native valve endocarditis (NVE), and our understanding of NVE caused by CoNS is incomplete. METHOD: The International Collaboration on Endocarditis-Prospective Cohort Study incl ... Full text Link to item Cite

Selective use of intranasal mupirocin and chlorhexidine bathing and the incidence of methicillin-resistant Staphylococcus aureus colonization and infection among intensive care unit patients.

Journal article Infect Control Hosp Epidemiol · October 2007 OBJECTIVE: To determine whether the use of chlorhexidine bathing and intranasal mupirocin therapy among patients colonized with methicillin-resistant Staphylococcus aureus (MRSA) would decrease the incidence of MRSA colonization and infection among intensi ... Full text Link to item Cite

Potential associations between hematogenous complications and bacterial genotype in Staphylococcus aureus infection.

Journal article J Infect Dis · September 1, 2007 BACKGROUND: The impact of bacterial clonality on infections caused by Staphylococcus aureus is unclear. METHODS: Three hundred seventy-nine S. aureus isolates (125 methicillin-resistant S. aureus [MRSA] and 254 methicillin-susceptible S. aureus [MSSA]) wer ... Full text Link to item Cite

Infective endocarditis caused by daptomycin-resistant Enterococcus faecalis: a case report.

Journal article Scand J Infect Dis · 2007 Daptomycin is a first-in-class antibiotic with efficacy against Gram-positive bacteria. We document the second report of daptomycin resistance in a clinical isolate of Enterococcus faecalis. ... Full text Link to item Cite