Scholars@Duke
Jeffrey Adam Kuller

Jeffrey Adam Kuller

Professor of Obstetrics and Gynecology
Obstetrics and Gynecology, Maternal Fetal Medicine
kulle001@mc.duke.edu
Box 3967 Med Ctr, 2608 Erwin Road; Suite 200, Durham, NC 27705
11001 Durant Road, Suite 114, Raleigh, NC 27614

Selected Publications

Familial Mediterranean Fever in Pregnancy.

Journal Article Obstet Gynecol Surv · October 2024 IMPORTANCE: Though the incidence of familial Mediterranean fever (FMF) in pregnancy is rare, understanding the etiology and symptomatology of FMF is essential for obstetric treatment of patients with FMF. OBJECTIVE: Familial Mediterranean fever is a heredi ... Full text Link to item Cite

Implications of Prenatal Cannabis Exposure on Childhood Neurodevelopmental Outcomes: A Summary of the Clinical Evidence.

Journal Article Obstet Gynecol Surv · October 2024 IMPORTANCE: Cannabis is commonly used by pregnant patients for alleviation of pregnancy-associated symptoms. Multiple national medical associations have recommended against prenatal cannabis use, yet misinformation regarding its safety and efficacy remains ... Full text Link to item Cite

Review of Systemic Lupus Erythematous.

Journal Article JAMA · September 3, 2024 Full text Link to item Cite

Therapeutic Rest as an Intervention in Early Labor: A Literature Review.

Journal Article Obstet Gynecol Surv · September 2024 IMPORTANCE: The latent phase of labor poses a challenge for pregnant patients due to the limited options available for pain relief and management. Therapeutic rest, an intervention involving medication administration during this phase, has shown promise in ... Full text Link to item Cite

Unusual Maternal and Fetal Findings With Cell-Free DNA Screening.

Journal Article Obstet Gynecol Surv · September 2024 IMPORTANCE: With advances in prenatal cell-free DNA (cfDNA) technology, the information available with cfDNA continues to expand beyond the common fetal aneuploidies such as trisomies 21, 18, and 13. Due to the admixture of maternal and fetal/placental DNA ... Full text Link to item Cite

Evaluation and Significance of Nonvisualization of the Cavum Septum Pellucidum on Prenatal Ultrasonography.

Journal Article Obstet Gynecol Surv · August 2024 IMPORTANCE: The identification of the cavum septum pellucidum (CSP) is an integral part of the routine second trimester fetal anatomy scan. The absence or nonvisualization of the CSP has significant clinical implications and requires further evaluation and ... Full text Link to item Cite

Suboptimally Controlled Diabetes in Pregnancy: A Review to Guide Antepartum and Delivery Management.

Journal Article Obstet Gynecol Surv · June 2024 IMPORTANCE: Diabetes mellitus is one of the most common complications in pregnancy with adverse maternal and neonatal risks proportional to the degree of suboptimal glycemic control, which is not well defined. Literature guiding providers in identifying an ... Full text Link to item Cite

Society for Maternal-Fetal Medicine Statement: RhD immune globulin after spontaneous or induced abortion at less than 12 weeks of gestation.

Journal Article Am J Obstet Gynecol · May 2024 Guidelines for the management of first-trimester spontaneous and induced abortion vary in terms of rhesus factor D (RhD) testing and RhD immune globulin (RhIg) administration. These existing guidelines are based on limited data that do not convincingly dem ... Full text Link to item Cite

Parvovirus B19 in Pregnancy.

Journal Article Obstet Gynecol Surv · May 2024 IMPORTANCE: Although the risk of parvovirus B19 infection during pregnancy and subsequent risk of adverse fetal outcome are low, understanding management practices is essential for proper treatment of fetuses with nonimmune hydrops fetalis. In addition, co ... Full text Link to item Cite

Cell-Free DNA Screening for Single-Gene Disorders.

Journal Article Obstet Gynecol Surv · March 2024 IMPORTANCE: In pregnancy, cell-free DNA (cfDNA) represents short fragments of placental DNA released into the maternal blood stream through natural cell death. Noninvasive prenatal screening with cfDNA is commonly used in pregnancy to screen for common ane ... Full text Link to item Cite

Society for Maternal-Fetal Medicine Statement: Clinical considerations for the prevention of respiratory syncytial virus disease in infants.

Journal Article Am J Obstet Gynecol · February 2024 Respiratory syncytial virus is a leading cause of lower respiratory tract illness globally in children aged <5 years. Each year, approximately 58,000 hospitalizations in the United States are attributed to respiratory syncytial virus. Infants aged ≤6 month ... Full text Link to item Cite

Luteal Phase Defects and Progesterone Supplementation.

Journal Article Obstet Gynecol Surv · February 2024 IMPORTANCE: Luteal phase defects (LPDs), or an insufficiency of progesterone production during the luteal phase of the menstrual cycle, have been identified as a potential cause of recurrent pregnancy loss (RPL), but its exact contribution to RPL is not we ... Full text Link to item Cite

Evidence Based Management of Labor.

Journal Article Obstet Gynecol Surv · January 2024 IMPORTANCE: Induction of labor (IOL) is a common obstetric intervention. Augmentation of labor and active management of the second stage is frequently required in obstetric practice. However, techniques around labor and induction management vary widely. Ev ... Full text Link to item Cite

First Trimester Ultrasound and Aneuploidy Screening in Twins.

Journal Article Clin Obstet Gynecol · December 1, 2023 All patients with twin pregnancy should have first trimester ultrasound and be offered screening for chromosomal aneuploidy as well as diagnostic testing. Screening for aneuploidy in twins presents unique challenges compared with singletons. Cell-free DNA ... Full text Link to item Cite

Optimizing Surgical Wound Care in Obstetrics and Gynecology.

Journal Article Obstet Gynecol Surv · October 2023 IMPORTANCE: Obstetrics and gynecology (OB/GYN) accounts for at least half of all open abdominal surgeries performed. Rates of surgical wound complications after open procedures in OB/GYN range from 5% to 35%. Therefore, optimizing management of surgical wo ... Full text Link to item Cite

Nicotine Use During Pregnancy: Cessation and Treatment Strategies.

Journal Article Obstet Gynecol Surv · October 2023 The use of tobacco and nicotine products during pregnancy is known to increase the risk of adverse effects on the fetus. Increased education and research have resulted in greater rates of smoking cessation during pregnancy, with a decline from 13.2% of pre ... Full text Link to item Cite

Prenatal Genetic Screening in Twin Pregnancy.

Journal Article Clin Obstet Gynecol · September 1, 2023 Twin pregnancy presents unique considerations for aneuploidy screening. Pre-test counseling regarding benefits, alternatives, and options for aneuploidy screening should be provided to all patients carrying twin pregnancy. This article aims to review the o ... Full text Link to item Cite

CenteringPregnancy: A Review of Implementation and Outcomes.

Journal Article Obstet Gynecol Surv · August 2023 IMPORTANCE: CenteringPregnancy (CP) is a model for group prenatal care associated with improved perinatal outcomes for preterm birth and low birthweight, increased rates of breastfeeding, and higher rates of patient and clinician satisfaction. OBJECTIVE: T ... Full text Link to item Cite

The Evolving Landscape of Genetic Carrier Screening: Clinical Considerations and Challenges.

Journal Article Obstet Gynecol Surv · August 2023 IMPORTANCE: Genetic carrier screening is performed to identify carriers of rare genetic diseases. Identification of carriers allows patients to make informed reproductive health choices and can decrease the incidence of genetic disorders with serious medic ... Full text Link to item Cite

The Risks and Benefits of Monoclonal Antibody Therapy During Pregnancy and Postpartum: Maternal, Obstetric, and Neonatal Considerations.

Journal Article Obstet Gynecol Surv · July 2023 IMPORTANCE: Autoimmune and rheumatologic conditions can lead to multiple adverse maternal, obstetric, and neonatal outcomes, especially if they flare during pregnancy. Although many medications to control these conditions exist, concerns regarding their sa ... Full text Link to item Cite

Antibiotic Recommendations After Postpartum Uterine Exploration or Instrumentation.

Journal Article Obstet Gynecol Surv · July 2023 IMPORTANCE: Multiple postpartum scenarios require uterine exploration or instrumentation. These may introduce bacteria into the uterus, increasing the risk of endometritis. Data on the use of antibiotics in these scenarios is limited, resulting in few guid ... Full text Link to item Cite

Transvaginal Ovarian Cyst Drainage in Third Trimester to Facilitate Vaginal Delivery.

Journal Article AJP Rep · July 2023 Adnexal masses in the third trimester of pregnancy may obstruct the pelvic outlet precluding labor induction and vaginal delivery. Expectant versus surgical management of adnexal cysts in pregnancy must carefully weigh maternal-fetal benefits and risks. Si ... Full text Link to item Cite

Peripartum Pubic Symphysis Diastasis.

Journal Article Obstet Gynecol Surv · June 2023 IMPORTANCE: Peripartum separation of the pubic symphysis is a rare but potentially severe complication of childbirth, which may lead to prolonged immobilization. Thus, prompt diagnosis and treatment are paramount. OBJECTIVE: The purpose of this review is t ... Full text Link to item Cite

A Rational and Standardized Prenatal Examination.

Journal Article Obstet Gynecol Surv · June 2023 IMPORTANCE: As prenatal care is in transition after the COVID-19 pandemic, reviewing fundamental physical examination approaches is necessary for providers examining obstetrical patients. OBJECTIVE: The objective of this review is 3-fold: (1) convey why th ... Full text Link to item Cite

Obstetric Care Consensus #11, Pregnancy at age 35 years or older.

Journal Article Am J Obstet Gynecol · March 2023 Centers for Disease Control and Prevention data from 2020 demonstrate the continued upward trend in the mean age of pregnant individuals in the United States. Observational studies demonstrate that pregnancy in older individuals is associated with increase ... Full text Link to item Cite

Society for Maternal-Fetal Medicine Consult Series #64: Systemic lupus erythematosus in pregnancy.

Journal Article Am J Obstet Gynecol · March 2023 Systemic lupus erythematosus (SLE) is a chronic, multisystem, inflammatory autoimmune disease characterized by relapses (commonly called "flares") and remission. Many organs may be involved, and although the manifestations are highly variable, the kidneys, ... Full text Link to item Cite

Well-Woman Care for the Female Cancer Survivor

Journal Article Topics in Obstetrics and Gynecology · January 2023 Open Access Cite

Group B Streptococcus and Pregnancy: Critical Concepts and Management Nuances.

Journal Article Obstet Gynecol Surv · December 2022 IMPORTANCE: Group B Streptococcus (GBS) is a common pathogen with an effective treatment. However, it remains a significant cause of neonatal sepsis, morbidity, and mortality. The screening and management of this infection are some of the first concepts le ... Full text Link to item Cite

Guidelines for Cystic Fibrosis Carrier Screening in the Prenatal/Preconception Period.

Journal Article Obstet Gynecol Surv · October 2022 IMPORTANCE: Cystic fibrosis (CF) is one of the most common autosomal recessive disorders. Carrier screening for CF should be offered to all women considering becoming pregnant or who are pregnant. Understanding the available screening tests, their limitati ... Full text Link to item Cite

Human Chorionic Gonadotropin-A Review of the Literature.

Journal Article Obstet Gynecol Surv · September 2022 IMPORTANCE: The measurement of human chorionic gonadotropin (hCG) levels in different body fluids is a commonly utilized tool in obstetrics and gynecology, as well as other fields. It is often one of the first steps in the medical workup of female patients ... Full text Link to item Cite

Fibroids and Fertility: A Comparison of Myomectomy and Uterine Artery Embolization on Fertility and Reproductive Outcomes.

Journal Article Obstet Gynecol Surv · August 2022 IMPORTANCE: Leiomyomata, or fibroids, are a common gynecological problem affecting many women of reproductive age. Historically, myomectomy is offered to women with symptomatic fibroids who desire to preserve fertility. More recently, uterine artery emboli ... Full text Link to item Cite

Pregnancy at Age 35 Years or Older: ACOG Obstetric Care Consensus No. 11.

Journal Article Obstet Gynecol · August 1, 2022 Centers for Disease Control and Prevention data from 2020 demonstrate the continued upward trend in the mean age of pregnant individuals in the United States. Observational studies demonstrate that pregnancy in older individuals is associated with increase ... Full text Link to item Cite

Breastfeeding: The Basics, the History, and Barriers in the Modern Day.

Journal Article Obstet Gynecol Surv · July 2022 IMPORTANCE: The scientific benefits of breastfeeding for the parent and baby are clear, but the goal is often simplified to "breast is best." Patients' decisions to breastfeed are more nuanced than this approach implies, and it is essential for providers t ... Full text Link to item Cite

Management of Preterm Premature Rupture of Membranes in the Late Preterm Period.

Journal Article Obstet Gynecol Surv · May 2022 IMPORTANCE: For patients who present with prelabor rupture of membrane (PROM) in the late preterm period (34 to 36 6/7 weeks), management remains unclear due to lack of consensus. However, recent guidelines have suggested that shared decision-making may be ... Full text Link to item Cite

Hypertensive Disorders of Pregnancy: Common Clinical Conundrums.

Journal Article Obstetrical & gynecological survey · April 2022 ImportanceHypertensive complications of pregnancy comprise 16% of maternal deaths in developed countries and 7.4% of deaths in the United States. Rates of preeclampsia increased 25% from 1987 to 2004, and rates of severe preeclampsia have increase ... Full text Cite

Prenatal Diagnosis of Arhinia.

Journal Article AJP Rep · April 2022 Arhinia is a rare congenital anomaly that is not typically associated with known genetic mutations and is usually discovered after an affected infant is born. Prenatal diagnosis is important because neonates with arhinia often require specialized respirato ... Full text Open Access Link to item Cite

Society for Maternal-Fetal Medicine Consult Series #60: Management of pregnancies resulting from in vitro fertilization.

Journal Article Am J Obstet Gynecol · March 2022 The use of assisted reproductive technology has increased in the United States in the past several decades. Although most of these pregnancies are uncomplicated, in vitro fertilization is associated with an increased risk for adverse perinatal outcomes pri ... Full text Link to item Cite

Benefits and Risks of Bilateral Salpingectomy Compared With Standard Tubal Ligation During Cesarean Delivery for Permanent Postpartum Contraception.

Journal Article Obstet Gynecol Surv · March 2022 IMPORTANCE: Ovarian cancer is the second most common gynecologic malignancy, but the most deadly female reproductive cancer in the United States. Epithelial ovarian cancer makes up approximately 90% of all cases and is responsible for more than 90% of ovar ... Full text Link to item Cite

Venomous Snake and Spider Bites in Pregnancy.

Journal Article Obstet Gynecol Surv · December 2021 IMPORTANCE: Venomous snake and spider bites are relatively rare in the Unites States and even more so in the pregnant population. However, the impact of a venomous bite, also known as an envenomation, can be serious in a pregnant patient. Thus, providers i ... Full text Link to item Cite

Management of Cerclage in Patients With Preterm Prelabor Rupture of Membranes.

Journal Article Obstet Gynecol Surv · November 2021 IMPORTANCE: Women undergoing cerclage placement remain at high risk for preterm labor and preterm prelabor rupture of membranes (PPROMs). The management of cervical cerclage after PPROM is controversial given the potential for prolonged latency when the ce ... Full text Link to item Cite

Society for Maternal-Fetal Medicine Consult Series #57: Evaluation and management of isolated soft ultrasound markers for aneuploidy in the second trimester: (Replaces Consults #10, Single umbilical artery, October 2010; #16, Isolated echogenic bowel diagnosed on second-trimester ultrasound, August 2011; #17, Evaluation and management of isolated renal pelviectasis on second-trimester ultrasound, December 2011; #25, Isolated fetal choroid plexus cysts, April 2013; #27, Isolated echogenic intracardiac focus, August 2013).

Journal Article Am J Obstet Gynecol · October 2021 Soft markers were originally introduced to prenatal ultrasonography to improve the detection of trisomy 21 over that achievable with age-based and serum screening strategies. As prenatal genetic screening strategies have greatly evolved in the last 2 decad ... Full text Link to item Cite

December 2020 (vol. 223, no. 6, pages B2-46)

Journal Article American Journal of Obstetrics and Gynecology · October 2021 Full text Cite

Society for Maternal-Fetal Medicine Consult Series #56: Hepatitis C in pregnancy-updated guidelines: Replaces Consult Number 43, November 2017.

Journal Article Am J Obstet Gynecol · September 2021 In the United States, it is estimated that 1% to 4% of pregnant women are infected with hepatitis C virus, which carries approximately a 5% risk of transmission from mother to infant. Hepatitis C virus can be transmitted to the infant in utero or during th ... Full text Link to item Cite

Peripartum Cardiomyopathy.

Journal Article Obstet Gynecol Surv · August 2021 IMPORTANCE: Peripartum cardiomyopathy is a rare form of heart failure due to left ventricular systolic dysfunction that affects women late in pregnancy and the postpartum period. A diagnosis of exclusion, peripartum cardiomyopathy can be difficult to diagn ... Full text Link to item Cite

Adnexal Masses in Pregnancy.

Journal Article Obstet Gynecol Surv · July 2021 IMPORTANCE: Adnexal masses are identified in approximately 0.05% to 2.4% of pregnancies, and more recent data note a higher incidence due to widespread use of antenatal ultrasound. Whereas most adnexal masses are benign, approximately 1% to 6% are malignan ... Full text Link to item Cite

Society for Maternal-Fetal Medicine Special Statement: Grading of Recommendations Assessment, Development, and Evaluation (GRADE) update.

Journal Article Am J Obstet Gynecol · April 2021 The Society for Maternal-Fetal Medicine Publications Committee first adopted the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system in 2013. This document provides an update on the Society for Maternal-Fetal Medicine Publicat ... Full text Link to item Cite

Spinal Muscular Atrophy: Inheritance, Screening, and Counseling for the Obstetric Provider.

Journal Article Obstet Gynecol Surv · March 2021 IMPORTANCE: Spinal muscular atrophy (SMA) confers significant risk of neonatal and infant morbidity and mortality. Screening women during or before pregnancy for carrier status of SMA presents an opportunity to identify pregnancies at risk for this potenti ... Full text Link to item Cite

Intrapartum and Postpartum Management of Intra-amniotic Infection.

Journal Article Obstet Gynecol Surv · February 2021 IMPORTANCE: Intra-amniotic infection (IAI) is a common condition with potentially devastating maternal and neonatal complications. However, there are incomplete data regarding the most effective antimicrobial treatment regimen for this condition. OBJECTIVE ... Full text Link to item Cite

The Risk of Congenital Anomalies by Fertility Treatment Modality.

Journal Article Obstet Gynecol Surv · January 2021 IMPORTANCE: Up to 4% of all births in developed nations involve assisted reproductive technology (ART), along with other fertility treatment modalities. Thus, ART pregnancies constitute an important epidemiologic population with a known increased risk of c ... Full text Link to item Cite

Preimplantation genetic testing: a review of current modalities

Journal Article F and S Reviews · January 1, 2021 In this review, we evaluate the different modalities of embryo genetic testing including preimplantation genetic testing for aneuploidy (PGT-A), for monogenic/single-gene abnormalities (PGT-M), and for chromosomal structural rearrangements (PGT-SR), with a ... Full text Cite

Fetal Ventriculomegaly.

Journal Article Am J Obstet Gynecol · December 2020 Full text Link to item Cite

Increased Risk of Aortic Dissection Associated With Pregnancy in Women With Turner Syndrome: A Systematic Review.

Journal Article Obstet Gynecol Surv · September 2020 IMPORTANCE: Turner syndrome (TS) is one of the most common chromosomal abnormalities in women. The condition is characterized by gonadal dysgenesis and is associated with structural cardiac abnormalities. Assisted reproductive technology with oocyte donati ... Full text Link to item Cite

Preconception Evaluation Before In Vitro Fertilization.

Journal Article Obstet Gynecol Surv · June 2020 IMPORTANCE: Infertility poses a substantial public health problem for women of reproductive age, in the United States and globally. Infertility can be overcome with a variety of emerging assisted reproductive technologies (ARTs). In vitro fertilization (IV ... Full text Link to item Cite

Exome Sequencing and Its Emerging Role in Prenatal Genetic Diagnosis.

Journal Article Obstet Gynecol Surv · May 2020 IMPORTANCE: Prenatal genetic diagnosis can guide pregnancy management and decision making. Genetic diagnosis has advanced rapidly, and chromosomal microarray has become widely used, in addition to conventional karyotype. Exome sequencing may provide an eve ... Full text Link to item Cite

A Review of Sleep Architecture and Sleep Changes During Pregnancy.

Journal Article Obstet Gynecol Surv · April 2020 IMPORTANCE: Poor sleep is widely recognized as a common complaint in pregnancy, and yet there are incomplete data on the exact nature of these complaints, what their implications for fetal and maternal health are, and how to best recognize and address thes ... Full text Link to item Cite

Electroconvulsive Therapy in Pregnancy: Safety, Best Practices, and Barriers to Care.

Journal Article Obstet Gynecol Surv · March 2020 IMPORTANCE: Approximately 10% to 16% of women meet diagnostic criteria for depression during pregnancy. Untreated maternal depression is associated with adverse pregnancy outcomes including premature birth, low birth weight, and fetal growth restriction. O ... Full text Link to item Cite

Hormonal management of menopausal symptoms in women with a history of gynecologic malignancy.

Journal Article Menopause · February 2020 OBJECTIVE: The aim of the study was to review the role of hormone therapy in menopausal patients with breast cancer and gynecologic malignancies. METHODS: We searched MEDLINE (via PubMed) using a combination of keywords and database-specific subject headin ... Full text Open Access Link to item Cite

Management Considerations for Recalcitrant Hyperemesis.

Journal Article Obstet Gynecol Surv · January 2020 IMPORTANCE: Hyperemesis gravidarum (HEG) affects 0.3% to 3% of pregnancies and requires additional therapies beyond those commonly used for less severe instances of nausea and vomiting of pregnancy (NVP). Differentiating between NVP and HEG is a vital yet ... Full text Link to item Cite

SMFM Fetal Anomalies Consult Series #3: Intracranial Anomalies

Journal Article AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY · 2020 Full text Cite

Preconception Genetic Screening

Chapter · January 1, 2020 Carrier screening is defined as testing performed on individuals to assess whether they carry one allele for a genetic condition for which they do not have the phenotype. This chapter reviews specific genetic conditions for which carrier screening is most ... Full text Cite

Prevention of Postpartum Venous Thromboembolism.

Journal Article Obstet Gynecol Surv · October 2019 IMPORTANCE: Postpartum venous thromboembolism (VTE) results in significant morbidity and mortality. The practicing obstetrician-gynecologist should have a plan for management and prevention. OBJECTIVE: The objective of this review is to familiarize obstetr ... Full text Link to item Cite

Syphilis in Pregnancy.

Journal Article Obstet Gynecol Surv · September 2019 IMPORTANCE: Since 2013, the United States has seen a rise in cases of congenital syphilis, culminating in a relative increase of 153% from 2013 to 2017 and 918 reported cases in 2017. In all, 50% to 80% of pregnant women with syphilis experience an adverse ... Full text Link to item Cite

Immune Thrombocytopenic Purpura in Pregnancy.

Journal Article Obstet Gynecol Surv · August 2019 IMPORTANCE: Immune thrombocytopenia purpura (ITP), an autoimmune disease characterized by destruction of platelets, is a hematological disorder that can present in both pregnant and nonpregnant patients. Although thrombocytopenia in pregnancy can be caused ... Full text Link to item Cite

Congenital Heart Disease: Prenatal Diagnosis and Genetic Associations.

Journal Article Obstet Gynecol Surv · August 2019 IMPORTANCE: Congenital heart disease (CHD) is a common cause of neonatal morbidity and mortality. Several genetic abnormalities have been linked to congenital cardiac disease. When diagnosed prenatally, appropriate evaluation can help optimize neonatal out ... Full text Link to item Cite

Listeriosis in Pregnancy: A Review.

Journal Article Obstet Gynecol Surv · June 2019 IMPORTANCE: Listeriosis is a rare foodborne condition that can cause serious health consequences in neonates and pregnant women. Listeria monocytogenes can be vertically transmitted to the fetus, resulting in adverse maternal, fetal, and neonatal outcomes. ... Full text Link to item Cite

Placental mesenchymal dysplasia: Key clinical and pathology features to aid in differentiation from molar pregnancy a case report

Journal Article Journal of Reproductive Medicine · June 1, 2019 BACKGROUND: Placental mesenchymal dysplasia (PMD) is a rare placental disorder characterized by placentomegaly. It carries a high incidence of adverse fetal outcomes, and its ultrasound appearance is similar to a partial hydatidiform mole and a complete hy ... Cite

Pharmacologic Treatment of Diabetes in Pregnancy.

Journal Article Obstet Gynecol Surv · May 2019 IMPORTANCE: Diabetes affects 6% to 9% of pregnancies, with gestational diabetes mellitus accounting for more than 90% of cases. Pregestational and gestational diabetes are associated with significant maternal and fetal risks; therefore, screening and treat ... Full text Link to item Cite

Acupuncture in Obstetrics and Gynecology

Journal Article Obstetrical and Gynecological Survey · April 1, 2019 Importance Acupuncture is a key component of therapy in traditional Chinese medicine. Only in the last few decades has acupuncture become popular in the United States. The mechanism behind acupuncture's effects on the body and brain has not been completely ... Full text Cite

Acupuncture in Obstetrics and Gynecology.

Journal Article Obstet Gynecol Surv · April 2019 IMPORTANCE: Acupuncture is a key component of therapy in traditional Chinese medicine. Only in the last few decades has acupuncture become popular in the United States. The mechanism behind acupuncture's effects on the body and brain has not been completel ... Full text Link to item Cite

Genetics for the Women's Health Trainee: A Five-Module Curriculum.

Journal Article MedEdPORTAL · January 18, 2019 INTRODUCTION: Genetics is ubiquitous in OB-GYN. However, data suggest that trainees feel underprepared to counsel patients about genetic testing, the nuances of which are becoming increasingly complicated. We sought to develop and implement a genetics curr ... Full text Link to item Cite

Tocolysis: A Review of the Literature.

Journal Article Obstet Gynecol Surv · January 2019 IMPORTANCE: Preterm delivery represents an important cause of infant morbidity and mortality. Various tocolytics have been studied with the objective of stopping preterm labor, increasing gestational age at delivery, and preventing complications related to ... Full text Link to item Cite

Perinatal genetics

Book · January 1, 2019 Get a quick, expert overview of the fast-changing field of perinatal genetics with this concise, practical resource. Drs. Mary Norton, Jeffrey A. Kuller, and Lorraine Dugoff fully cover the clinically relevant topics that are key to providers who care for ... Full text Cite

Ultrasound markers for aneuploidy in the second trimester

Chapter · January 1, 2019 Soft ultrasound markers were initially described as a screening method for trisomy 21 to improve the detection rate over that based on age-related risk alone. In this chapter, we discuss the implications of isolated soft markers in the context of contempor ... Full text Cite

CONGENITAL HEART DISEASE AND PREGNANCY

Chapter · January 1, 2019 Congenital heart disease (CHD) refers to a “gross structural abnormality of the heart or intrathoracic great vessels that is actually or potentially of functional significance” [1]. Congenital heart disease is the most common congenital anomaly and makes u ... Cite

Obstetric practice patterns in pregnancies complicated by fetal trisomy 13 or 18.

Journal Article J Matern Fetal Neonatal Med · September 2018 PURPOSE: Describe practice patterns among obstetrician/gynecologists (OB/GYNs) when caring for women with pregnancy complicated by fetal trisomy 13 (T13) or 18 (T18) and compare these between maternal-fetal medicine (MFM) and non-MFM providers. MATERIALS A ... Full text Link to item Cite

Trisomy 13 and the risk of gestational hypertensive disorders: a population-based study.

Journal Article J Matern Fetal Neonatal Med · August 2018 PURPOSE: To describe the rate and severity of gestational hypertensive disorders (GHDs) in pregnancies complicated by trisomy 13 (T13). MATERIALS AND METHODS: Retrospective cohort study of singleton deliveries in California from 2005 to 2008 using vital st ... Full text Link to item Cite

What are the required components of pre- and post-test counseling?

Journal Article Semin Perinatol · August 2018 Prenatal care providers are faced with a myriad of decisions about how to offer genetic screening and testing in ways that are appropriate to their patient population and their workflow. Among the critical issues brought to the forefront of rapidly advanci ... Full text Link to item Cite

Mild fetal ventriculomegaly: diagnosis, evaluation, and management.

Journal Article Am J Obstet Gynecol · July 2018 Ventriculomegaly is defined as dilation of the fetal cerebral ventricles and is a relatively common finding on prenatal ultrasound. The purpose of this document is to review the diagnosis, evaluation, and management of mild fetal ventriculomegaly. When enl ... Full text Link to item Cite

Minimizing the Risk of Perinatal Human Immunodeficiency Virus Transmission.

Journal Article Obstet Gynecol Surv · July 2018 IMPORTANCE: There are approximately 284,500 adolescent and adult women living with human immunodeficiency virus (HIV) in the United States. It is estimated that approximately 8500 of these women give birth annually. While the rate of perinatal transmission ... Full text Link to item Cite

Radiologic Aspects of the Diagnosis of Pulmonary Embolism in Pregnancy.

Journal Article Clin Obstet Gynecol · June 2018 Pulmonary embolism in pregnancy is a leading cause of maternal mortality. The clinical presentation is often nonspecific, making imaging essential for accurate diagnosis. After reviewing the literature on the radiologic diagnosis of pulmonary embolism in p ... Full text Link to item Cite

Inherited Metabolic Disorders: Implications for the Obstetrician-Gynecologist.

Journal Article Obstet Gynecol Surv · June 2018 IMPORTANCE: Inherited metabolic disorders, or inborn errors of metabolism, can result in significant morbidity and mortality. Advances in genetic testing, including newborn screening and prenatal carrier screening, continue to increase awareness and highli ... Full text Link to item Cite

Hepatitis C in pregnancy: Screening, treatment, and management

Journal Article Contemporary Ob/Gyn · May 1, 2018 Cite

Prenatal genetic diagnosis of Neu-Laxova syndrome.

Journal Article J Obstet Gynaecol · April 2018 Full text Link to item Cite

Intrahepatic Cholestasis of Pregnancy: A Review of Diagnosis and Management.

Journal Article Obstet Gynecol Surv · February 2018 IMPORTANCE: Intrahepatic cholestasis of pregnancy (ICP) complicates approximately 0.2% to 2% of pregnancies and can lead to increased fetal risks in pregnancy. OBJECTIVE: This review aims to increase the knowledge of women's health care providers regarding ... Full text Link to item Cite

Evaluation and Management of Maternal Congenital Heart Disease: A Review.

Journal Article Obstet Gynecol Surv · February 2018 OBJECTIVE: Congenital heart defects represent the most common major congenital anomalies. The objective of this review was to define the most common forms of congenital heart disease (CHD) in pregnancy, outline preconception counseling, discuss the associa ... Full text Link to item Cite

Hepatitis C in pregnancy: screening, treatment, and management.

Journal Article Am J Obstet Gynecol · November 2017 In the United States, 1-2.5% of pregnant women are infected with hepatitis C virus, which carries an approximately 5% risk of transmission from mother to infant. Hepatitis C virus can be transmitted to the infant in utero or during the peripartum period, a ... Full text Link to item Cite

What's New in Prenatal Genetics? A Review of Current Recommendations and Guidelines.

Journal Article Obstet Gynecol Surv · October 2017 IMPORTANCE: The rapid development of prenatal genetic testing and screening tools and choices constantly challenges clinicians to stay up to date on current best practice. OBJECTIVE: We sought to review, compare, and summarize recent national society guide ... Full text Link to item Cite

Committee Opinion No. 720: Maternal-Fetal Surgery for Myelomeningocele.

Journal Article Obstet Gynecol · September 2017 Myelomeningocele, a severe form of spina bifida, occurs in approximately 1 in 3,000 live births in the United States. The extent of disability is generally related to the level of the myelomeningocele defect, with a higher upper level of lesion generally c ... Full text Link to item Cite

Pregnancy Outcomes Following Cervical Conization or Loop Electrosurgical Excision Procedures.

Journal Article Obstet Gynecol Surv · August 2017 BACKGROUND: Conservative excisional measures used to manage cervical dysplasia are often cited as risk factors for preterm labor in subsequent pregnancies. OBJECTIVE: We performed an evidence-based review of the obstetric complications following excisional ... Full text Link to item Cite

Body Mass Index 50 kg/m2 and Beyond: Perioperative Care of Pregnant Women With Superobesity Undergoing Cesarean Delivery.

Journal Article Obstet Gynecol Surv · August 2017 IMPORTANCE: Superobesity, defined as body mass index 50 kg/m2 or greater, is the fastest-growing obesity group in the United States. Currently, 2% of pregnant women in the United States are superobese, and 50% will deliver via cesarean delivery. OBJECTIVE: ... Full text Link to item Cite

Hepatitis C in Pregnancy: Review of Current Knowledge and Updated Recommendations for Management.

Journal Article Obstet Gynecol Surv · June 2017 IMPORTANCE: An estimated 1% to 2.5% of pregnant women in the United States are infected with hepatitis C virus (HCV), which carries approximately a 6% risk of mother-to-infant transmission. OBJECTIVES: The aims of this article are to review the current evi ... Full text Link to item Cite

The role of ultrasound in women who undergo cell-free DNA screening.

Journal Article Am J Obstet Gynecol · March 2017 The introduction of cell-free DNA screening for aneuploidy into obstetric practice in 2011 revolutionized the strategies utilized for prenatal testing. The purpose of this document is to review the current data on the role of ultrasound in women who have u ... Full text Link to item Cite

Diagnosis and Management of Congenital Uterine Anomalies in Pregnancy.

Journal Article Obstet Gynecol Surv · March 2017 IMPORTANCE: Congenital uterine anomalies (CUAs) are strongly associated with adverse fertility and pregnancy outcomes. Health care providers must be able to diagnose these anomalies, understand their impact, and counsel women on interventions that might im ... Full text Link to item Cite

Risk Factors for Birth Defects.

Journal Article Obstet Gynecol Surv · February 2017 IMPORTANCE: Major congenital abnormalities, or birth defects, carry significant medical, surgical, cosmetic, or lifestyle consequences. Such abnormalities may be syndromic, involving multiple organ systems, or can be isolated. Overall, 2% to 4% of live bir ... Full text Link to item Cite

Society for Maternal-Fetal Medicine (vol 215, pg B2, 2016)

Journal Article AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY · February 1, 2017 Link to item Cite

Ultrasound Examination of the Fetal Heart.

Journal Article Obstet Gynecol Surv · January 2017 Congenital heart disease (CHD) occurs in 4-13 per 1000 births in the United States. While many risk factors for CHD have been identified, more than 90% of cases occur in low-risk patients. Guidelines for fetal cardiac screening during the second trimester ... Full text Link to item Cite

Reproductive genetics

Chapter · 2017 Cite

The use of chromosomal microarray for prenatal diagnosis.

Journal Article Am J Obstet Gynecol · October 2016 Chromosomal microarray analysis is a high-resolution, whole-genome technique used to identify chromosomal abnormalities, including those detected by conventional cytogenetic techniques, as well as small submicroscopic deletions and duplications referred to ... Full text Link to item Cite

Gastroschisis: A Review of Management and Outcomes.

Journal Article Obstet Gynecol Surv · September 2016 We performed an evidence-based review of the obstetrical management of gastroschisis. Gastroschisis is an abdominal wall defect, which has increased in frequency in recent decades. There is variation of prevalence by ethnicity and several known maternal ri ... Full text Link to item Cite

Cell-Free DNA Screening: Complexities and Challenges of Clinical Implementation.

Journal Article Obstet Gynecol Surv · August 2016 Screening for fetal aneuploidy in pregnant women using cell-free DNA has increased dramatically since the technology became commercially available in 2011. Since that time, numerous trials have demonstrated high sensitivity and specificity to screen for co ... Full text Link to item Cite

Pregnancy Management After Bariatric Surgery.

Journal Article Obstet Gynecol Surv · June 2016 Obesity is a source of major morbidity and mortality and is a growing concern worldwide. Maternal obesity is associated with increased maternal and fetal risks during pregnancy. Bariatric surgery has emerged as one of the most sustainable treatments for se ... Full text Link to item Cite

Management Considerations for Ongoing Pregnancies Complicated by Trisomy 13 and 18.

Journal Article Obstet Gynecol Surv · May 2016 Pregnancies complicated by trisomy 13 (T13) or trisomy 18 (T18) present unique challenges for obstetric management. From the initial diagnosis, the task of counseling these women and families is difficult because fetal and neonatal outcomes vary depending ... Full text Link to item Cite

Abnormalities of Fetal Situs: An Overview and Literature Review.

Journal Article Obstet Gynecol Surv · January 2016 The incidence of congenital heart disease is most commonly reported in 8 per 1000 live births. Situs anomalies are among the least common forms of congenital heart disease. This study defines situs and describes the variations of fetal situs anomalies. Sit ... Full text Link to item Cite

Perinatal Considerations in Women With Previous Diagnosis of Cancer.

Journal Article Obstet Gynecol Surv · December 2015 As the average age that women have their first child increases and cancer therapies improve survival, obstetricians are more likely to care for pregnant women who have survived cancer. Managing these pregnancies can be challenging, as they may be associate ... Full text Link to item Cite

Controversies in the Management of Isolated Congenital Atrioventricular Block.

Journal Article Obstet Gynecol Surv · August 2015 Congenital atrioventricular block (CAVB) affects approximately 2% of fetuses of mothers with anti-Ro or anti-La antibodies, regardless of maternal rheumatologic symptoms. Anti-Ro and anti-La antibodies are antinuclear antibodies commonly found in autoimmun ... Full text Link to item Cite

Chikungunya Fever: Obstetric Considerations on an Emerging Virus.

Journal Article Obstet Gynecol Surv · July 2015 Chikungunya fever is an increasingly common viral infection transmitted to humans by species of the Aedes mosquitoes. Characterized by fevers, myalgias, arthralgias, headache, and rash, the infection is endemic to tropical areas. However, identification of ... Full text Link to item Cite

Cancer and pregnancy: the clinician's perspective.

Journal Article Obstet Gynecol Surv · May 2014 Although uncommon, the incidence of cancer complicating pregnancy is increasing. Managing these pregnancies creates many diagnostic, therapeutic, and ethical dilemmas for the patient, her family, and the medical care team. Despite concerns for fetal well-b ... Full text Link to item Cite

Arthropod-borne bacterial diseases in pregnancy.

Journal Article Obstet Gynecol Surv · September 2013 Arthropod-borne bacterial diseases affect more than 25,000 Americans every year and thousands more around the world. These infections present a diagnostic dilemma for clinicians because they mimic many other pathologic conditions and are often low on or ab ... Full text Link to item Cite

Antenatal surveillance of fetal growth restriction.

Journal Article Obstet Gynecol Surv · September 2012 Fetal growth restriction is a complex problem in modern obstetrics. It is a condition of suboptimal fetal growth based on a genetically predetermined potential and affects approximately 5% to 10% of pregnancies. It is traditionally defined as an estimated ... Full text Link to item Cite

The impact of familial Mediterranean fever on women's health.

Journal Article Obstet Gynecol Surv · June 2012 Familial Mediterranean fever (FMF) is the most common hereditary recurrent febrile disorder, characterized by the sudden onset of high fever and severe abdominal pain. The implications of this disorder on a woman's health are significant and not well known ... Full text Link to item Cite

Influenza and tetanus, diphtheria, and acellular pertussis vaccinations during pregnancy.

Journal Article Obstet Gynecol Surv · April 2012 UNLABELLED: Vaccinations in pregnancy are an important aspect of prenatal care and of improving not only maternal health but also neonatal outcomes. Only 2 vaccines are specifically recommended during pregnancy: influenza and tetanus, diphtheria, and acell ... Full text Link to item Cite

Antidepressants in pregnancy: a review of commonly prescribed medications.

Journal Article Obstet Gynecol Surv · December 2011 UNLABELLED: Perinatal depression is an increasingly common comorbidity of pregnancy and is associated with adverse birth outcomes. Newer classes of antidepressants have been developed with a variety of mechanisms and improved side effect profiles. There is ... Full text Link to item Cite

Maternal valvular heart disease in pregnancy.

Journal Article Obstet Gynecol Surv · September 2011 UNLABELLED: Valvular heart disease is common in pregnancy. Maternal physiology changes significantly during gestation with substantial increases in cardiac output and blood volume; this can cause unmasking or worsening of cardiac disease. Acquired valvular ... Full text Link to item Cite

Parasitic infections in pregnancy.

Journal Article Obstet Gynecol Surv · August 2011 UNLABELLED: Parasitic infections affect tens of millions of pregnant women worldwide. These infections lead directly and indirectly to a spectrum of adverse maternal and fetal/placental effects. With the increase in global travel, healthcare providers will ... Full text Link to item Cite

Gynecologic and Obstetric Investigation: Foreword

Journal Article Gynecologic and Obstetric Investigation · August 16, 2005 Full text Cite

First trimester screening.

Journal Article Gynecol Obstet Invest · 2005 Featured Publication Screening for aneuploidy has traditionally been reserved for women of advanced maternal age. More recent advances in serum screening and ultrasound technology have allowed women of all ages to be offered screening in the second and even first trimester. Th ... Full text Link to item Cite

Fetal ovarian cyst

Journal Article Journal of Diagnostic Medical Sonography · November 1, 2004 This case report demonstrates a complex fetal ovarian cyst. A fetal ovarian cyst is a fluid-filled ovarian tumor. Ovarian cysts are rarely detected in infants but are slightly more common on fetal sonography. The majority of cysts are benign corpus luteal ... Full text Cite

Omphalocele: clinical outcomes in cases with normal karyotypes.

Journal Article Am J Obstet Gynecol · January 2004 Featured Publication OBJECTIVE: This study was undertaken to examine neonatal outcomes in karyotypically normal cases of omphalocele with respect to mode of delivery, presence of associated anomalies, presence of extracorporeal liver, and method of abdominal wall closure. STUD ... Full text Link to item Cite

Gastroschisis: the effect of labor and ruptured membranes on neonatal outcome.

Journal Article Am J Obstet Gynecol · December 2003 Featured Publication OBJECTIVES: The purpose of this study was to examine the relationship between labor and ruptured membranes on the neonatal outcome of infants with gastroschisis. STUDY DESIGN: We reviewed the outcomes of 60 neonates who were prenatally diagnosed with gastr ... Full text Link to item Cite

Thrombophilias and recurrent miscarriage.

Journal Article Obstet Gynecol Surv · October 2002 Featured Publication Inherited and acquired thrombophilias have been associated with recurrent pregnancy loss. Over recent years our ability to detect protein and genetic abnormalities responsible for thrombotic tendency has improved. We are now left with the task of decipheri ... Full text Link to item Cite

Hyperemesis gravidarum complicated by Wernicke's encephalopathy.

Journal Article Obstet Gynecol · May 2002 Featured Publication BACKGROUND: Wernicke's encephalopathy is usually associated with alcohol abuse, but can also occur with hyperemesis gravidarum. The effect of delay in thiamine replacement on fetal outcomes is unknown. We present a case of this complication. CASE: A primip ... Full text Link to item Cite

Use of magnetic resonance imaging and ultrasound in the antenatal diagnosis of placenta accreta.

Journal Article J Soc Gynecol Investig · 2002 OBJECTIVE: To determine whether magnetic resonance imaging (MRI) and ultrasound (US) are effective methods for diagnosing placenta accreta, increta, or percreta antenatally. METHODS: We retrospectively reviewed radiologic reports of patients who had the di ... Full text Link to item Cite

Disposition of sperm donors with resultant abnormal pregnancies.

Journal Article Hum Reprod · August 2001 Featured Publication We wished to determine how clinicians manage sperm donors whose offspring have chromosomal or structural abnormalities. A directed, multiple-choice survey was given to reproductive endocrinologists and obstetrical geneticists to assess management of sperm ... Full text Link to item Cite

Pregnancy in transplant recipients.

Journal Article Obstet Gynecol Surv · May 2001 Featured Publication A growing number of transplant recipients are women of reproductive age or children who will reach reproductive age. Thus, menstrual function and pregnancy increasingly are important issues because fertility is restored to women who were previously unable ... Full text Link to item Cite

Renal biopsy and pregnancy.

Journal Article Am J Obstet Gynecol · May 2001 Featured Publication OBJECTIVE: Our aim was to review our experience with renal biopsy in pregnancy. STUDY DESIGN: We reviewed 18 renal biopsies performed during pregnancy or in the immediate postpartum period at the University of North Carolina. Indications, histopathologic f ... Full text Link to item Cite

Preeclampsia into eclampsia: toward a new paradigm.

Journal Article Am J Obstet Gynecol · June 2000 Featured Publication OBJECTIVE: This study was undertaken to characterize aspects of the natural history of eclampsia. STUDY DESIGN: A retrospective analysis was performed on the records of patients with eclampsia who were delivered at two tertiary care hospitals. RESULTS: Fif ... Full text Link to item Cite

Peripartum cardiomyopathy: a review of the literature.

Journal Article Obstet Gynecol Surv · August 1999 UNLABELLED: Peripartum cardiomyopathy (PPCM) is a poorly characterized, rare form of cardiomyopathy. The etiology of PPCM is unknown, but viral, autoimmune, and idiopathic causes may contribute. The presentation is similar to other forms of congestive hear ... Full text Link to item Cite

Urinary incontinence in pregnancy and the puerperium: a prospective study.

Journal Article Am J Obstet Gynecol · August 1999 Featured Publication OBJECTIVE: Pregnancy and childbirth are commonly thought to be associated with the development of urinary incontinence and lower urinary tract symptoms. The purpose of this study was to assess the relationship, if any, between pregnancy and the development ... Full text Link to item Cite

Management of cervical cerclage after preterm premature rupture of membranes.

Journal Article Obstet Gynecol Surv · June 1999 Featured Publication The optimal management of preterm premature rupture of membranes (PPROM) in a patient with a cerclage is controversial. The issues are whether the latency period between rupture of membranes and delivery is decreased if the cerclage is removed and whether ... Full text Link to item Cite

Cystic fibrosis and the National Institutes of Health consensus statement: are obstetrician-gynecologists ready to comply?

Journal Article Obstet Gynecol · April 1999 Featured Publication OBJECTIVE: To determine if obstetrician-gynecologists are ready to comply with the April 1997 National Institutes of Health (NIH) consensus statement regarding carrier screening for cystic fibrosis. METHODS: A multiple-choice questionnaire was mailed to al ... Full text Link to item Cite

What are the clinical implications?

Journal Article Am J Obstet Gynecol · February 1999 Full text Link to item Cite

Central hemodynamic effects of an oxytocin receptor antagonist (atosiban) in the isolated, perfused rat heart.

Journal Article J Soc Gynecol Investig · 1999 Featured Publication OBJECTIVE: Atosiban is a selective oxytocin receptor antagonist capable of inhibiting oxytocin-induced contractility of the uterus. Trials of this agent in intact animals and women as a tocolytic agent for preterm labor have shown atosiban to be devoid of ... Link to item Cite

Prenatal diagnosis and perinatal management of fetal sacrococcygeal teratoma.

Journal Article Am J Perinatol · 1999 Sacrococcygeal teratoma is the most common fetal neoplasm, with an incidence of 1 in 40,000 births. Fetuses with this malformation are at risk for significant perinatal morbidity and mortality. We identified nine fetuses with sacrococcygeal teratomas that ... Full text Link to item Cite

Prenatal diagnosis of mosaic trisomy 13: a case report.

Journal Article Prenat Diagn · September 1998 Featured Publication While the clinical features associated with full trisomy 13 have been well characterized, the clinical outcome associated with mosaic trisomy 13 is much less clear. The medical literature reports a broad range of possible clinical outcomes from severe ment ... Full text Link to item Cite

Does epidural analgesia cause dystocia?

Journal Article J Clin Anesth · February 1998 STUDY OBJECTIVE: To analyze the effects of epidural analgesia for labor when dystocia occurs. DESIGN: Retrospective cohort study. SETTING: Academic health center. PATIENTS: 641 low risk, nulliparous women in spontaneous labor. INTERVENTIONS: 406 (63%) wome ... Full text Link to item Cite

Perinatal outcomes in women with systemic lupus erythematosus.

Journal Article J Perinatol · 1998 Featured Publication OBJECTIVE: Pregnancies of women with systemic lupus erythematosus (SLE) were studied to assess the effects interaction of this disease and pregnancy. STUDY DESIGN: Charts of pregnant women with a discharge diagnosis of lupus were reviewed. Inclusion criter ... Link to item Cite

Risk of preeclampsia in second-trimester triploid pregnancies.

Journal Article Obstet Gynecol · December 1997 OBJECTIVE: To determine the magnitude of the risk and the predictive clinical characteristics for development of preeclampsia when triploidy is diagnosed in the second trimester. METHODS: A retrospective analysis of databases maintained by the cytogenetics ... Full text Link to item Cite

Vaginal delivery is associated with occult disruption of the anal sphincter mechanism.

Journal Article Am J Perinatol · October 1997 Childbirth is thought to be an important cause of pelvic floor dysfunction. Heretofore, this has been thought due to pudendal denervation. Endovaginal sonography allows thorough assessment of the anorectum and in this study was used to assess nulliparous w ... Full text Link to item Cite

Clinical Crossroads: a 36-year-old woman recuperating from stroke.

Journal Article JAMA · October 1, 1997 Featured Publication Link to item Cite

A guide to the safety of CNS-active agents during breastfeeding.

Journal Article Drug Saf · August 1997 For most agents with CNS activity, there are limited data regarding their safety in breastfeeding. Any decision to institute treatment for a neurological or psychiatric disorder must weigh the benefits of maternal treatment against the potential harm to th ... Full text Link to item Cite

Prenatal diagnosis using fetal cells from the maternal circulation.

Journal Article Obstet Gynecol Surv · July 1997 Current prenatal diagnosis relies on invasive methods such as amniocentesis and chorionic villus sampling. Because these methods carry a low, but finite risk of pregnancy loss, noninvasive genetic screening techniques are the focus of intense research. Iso ... Full text Link to item Cite

Transdermal nicotine replacement in pregnancy: maternal pharmacokinetics and fetal effects.

Journal Article Am J Obstet Gynecol · May 1997 OBJECTIVE: Our purpose was to measure any short-term effects that the transdermal nicotine replacement system may have in pregnancy and to verify salivary nicotine and cotinine levels during patch placement. STUDY DESIGN: After customary smoking cessation ... Full text Link to item Cite

Advanced maternal age and perinatal outcome: oocyte recipiency versus natural conception.

Journal Article Obstet Gynecol · April 1997 OBJECTIVE: To compare perinatal outcome in older oocyte recipients with that in women of advanced maternal age who conceived without assisted reproductive technologies. METHODS: We performed a retrospective cohort study of 46 oocyte recipients and 49 women ... Full text Link to item Cite

Analysis of the risks associated with calcium channel blockade: implications for the obstetrician-gynecologist.

Journal Article Obstet Gynecol Surv · March 1997 Calcium channel antagonists are widely prescribed in obstetrics and gynecology for blood pressure control and tocolysis. Concerns have recently arisen regarding the safety of these agents. Several studies found that short-acting forms of calcium channel bl ... Full text Link to item Cite

Storage of newborn stem cells for future use.

Journal Article Obstet Gynecol · February 1997 Human placental cord blood contains a large number of hematopoietic progenitor cells, which could be used as a source of stem cells for the treatment of hematologic disorders and malignancies. Advantages of cord blood use include noninvasive collection, lo ... Full text Link to item Cite

Vaginal delivery is associated with occult disruption of the anal sphincter mechanism

Journal Article American Journal of Perinatology · 1997 Childbirth is thought to be an important cause of pelvic floor dysfunction. Heretofore, this has been thought due to pudendal denervation. Endovaginal sonography allows thorough assessment of the anorectum and in this study was used to assess nulliparous w ... Cite

Aneurysm of the vein of Galen: prenatal diagnosis and perinatal management.

Journal Article Am J Perinatol · November 1996 An aneurysm of the vein of Galen is a rare arteriovenous malformation of the central nervous system. Fetal manifestations have included nonimmune hydrops, hydrocephalus, and intracranial hemorrhage. This anomaly may be diagnosed prenatally by several imagi ... Full text Link to item Cite

Prenatal ultrasonographic findings associated with short bowel syndrome in two fetuses with gastroschisis.

Journal Article Obstet Gynecol · October 1996 BACKGROUND: Studies on the importance of prenatal ultrasonographic findings in gastroschisis have shown variable significance in predicting neonatal outcome. We report two cases of short bowel syndrome and poor neonatal outcome that had interesting prenata ... Full text Link to item Cite

Assessment of the post-term pregnancy.

Journal Article Am Fam Physician · August 1996 A post-term pregnancy is one that lasts beyond 42 weeks of confirmed gestational age. The goal of management in the post-term pregnancy is to avoid stillbirth, meconium aspiration and neonatal death. Ultrasonography obtained at term does not accurately pre ... Link to item Cite

Statewide assessment of a behavioral intervention to reduce cigarette smoking by pregnant women.

Journal Article Am J Obstet Gynecol · August 1996 OBJECTIVE: Smoking in pregnancy is the foremost cause of preventable perinatal mortality. We have demonstrated that a behavioral intervention can alter smoking in pregnant women. We tested the utility of this intervention at multiple sites in varied settin ... Full text Link to item Cite

Fatal lupus pleuritis presenting in pregnancy. A case report.

Journal Article J Reprod Med · July 1996 BACKGROUND: Lupus, one of the most common autoimmune diseases in pregnancy, may involve multiple organ systems with varying severity. The diagnosis and treatment of the disease may be complicated by the physiologic changes of pregnancy. CASE: A 22-year-old ... Link to item Cite

Cesarean delivery for fetal malformations.

Journal Article Obstet Gynecol Surv · June 1996 We reviewed existing data on fetal abnormalities to provide guidelines to determine which conditions have an improved neonatal outcome by cesarean delivery. We used Medline database to search for English language papers on a variety of fetal conditions tha ... Full text Link to item Cite

Issues associated with prenatal testing for fetal abnormalities - Reply

Journal Article AMERICAN FAMILY PHYSICIAN · June 1, 1996 Link to item Cite

Perinatal management of a lingual teratoma.

Journal Article Obstet Gynecol · May 1996 BACKGROUND: Teratomas of the head and neck are rare and occur almost exclusively in neonates. Prenatal diagnosis of these tumors allows for a carefully planned delivery that maintains an open airway and potentially improves perinatal outcome. We report the ... Link to item Cite

Pharmacologic treatment of psychiatric disease in pregnancy and lactation: fetal and neonatal effects.

Journal Article Obstet Gynecol · May 1996 OBJECTIVE: To review published data pertaining to safety of psychoactive drugs used to treat psychiatric disorders during pregnancy and lactation. DATA SOURCES: A computerized search of articles published through July 1995 was performed on the MEDLINE data ... Full text Link to item Cite

Multiple congenital malformations in an infant prenatally diagnosed with mosaicism for dup(lq) and del(Xq).

Journal Article Clin Genet · April 1996 After ultrasound diagnosis of a fetus with severe hydrocephalus and Dandy-Walker malformation, amniocentesis revealed chromosomal mosaicism for dup(lq) and del(Xq). The neonate had dysmorphic facial features, vertebral abnormalities, and pulmonary hypoplas ... Full text Link to item Cite

Cancer in pregnancy: a review of the literature. Part I.

Journal Article Obstet Gynecol Surv · February 1996 Cancer is an important cause of death in the United States in women of childbearing age. Approximately 1 per 1000 pregnant women will develop cancer. This review (Part II follows in this issue) examines the diagnosis, prognosis, and management of cancer du ... Full text Link to item Cite

Pregnancy in a patient with Goodpasture syndrome and renal transplantation.

Journal Article Am J Perinatol · February 1996 Patients with Goodpasture syndrome have classically had decreased fertility and associated pregnancy wastage. Renal transplantation can increase the likelihood of successful pregnancy. We describe a patient who carried a pregnancy into the third trimester ... Full text Link to item Cite

Cancer in pregnancy: a review of the literature. Part II.

Journal Article Obstet Gynecol Surv · February 1996 Full text Link to item Cite

An association between fetal parvovirus B19 infection and fetal anomalies: a report of two cases.

Journal Article Am J Perinatol · January 1996 The association between fetal parvovirus B19 infection and hydrops was first reported in 1984. The virus has a predilection for the erythroid cell line, which in the fetus may produce anemia. Recent cases of parvovirus infection in other fetal cell lines h ... Full text Link to item Cite

Magnetic resonance imaging of the pelvic floor in the postpartum patient.

Journal Article Int Urogynecol J Pelvic Floor Dysfunct · 1996 Magnetic resonance imaging (MRI) was used to assess anatomical changes in the pelvic floor after childbirth. Six women underwent serial MRI examination within 30 hours and at 1 week, 2 weeks, 6 weeks and 6 months after delivery; 8 additional women were stu ... Full text Link to item Cite

Fetal ovarian torsion appearing as a solid abdominal mass.

Journal Article J Perinatol · 1996 Fetal and neonatal ovarian cysts can be small asymptomatic lucencies or large symptomatic echocomplex masses that can cause intestinal obstruction and peritonitis. Solid masses are the most rare form of ovarian cysts. A fetus, anatomically unremarkable at ... Link to item Cite

Contemporary approaches to prenatal diagnosis.

Journal Article Am Fam Physician · December 1995 A variety of options for prenatal diagnosis are available to the pregnant woman. Maternal serum analyte analysis, performed between 15 and 20 weeks' gestation, provides a screening test for fetal neural tube defects and aneuploidy in low-risk pregnancies. ... Link to item Cite

Varicella during pregnancy. Maternal and fetal effects.

Journal Article West J Med · November 1995 To determine the characteristics of maternal varicella at our institution, we reviewed all cases of primary varicella in pregnancy. Using a perinatal database that summarizes all obstetric admissions, we reviewed the medical records of women with varicella ... Link to item Cite

GASTROSCHISIS - INTRAABDOMINAL BOWELS DILATATION MAY PREDICT SHORT-BOWEL SYNDROME

Journal Article AMERICAN JOURNAL OF HUMAN GENETICS · October 1, 1995 Link to item Cite

Myocardial infarction and coronary artery dissection in pregnancy.

Journal Article Am J Perinatol · September 1995 Myocardial infarction associated with pregnancy is a relatively rare event, usually related to maternal risk factors for ischemic heart disease such as hypertension and diabetes mellitus. Coronary artery dissection represents an even more uncommon event an ... Full text Link to item Cite

Alpha 1-antitrypsin deficiency and pregnancy.

Journal Article Am J Perinatol · September 1995 Alpha1-antitrypsin deficiency is an inherited pulmonary disorder which results from a deficiency of a major plasma protease inhibitor. The onset and severity of symptoms vary widely and depend on the genotype and whether the patient smokes cigarettes. Alph ... Full text Link to item Cite

Fetal porencephaly: a review of etiology, diagnosis, and prognosis.

Journal Article Obstet Gynecol Surv · September 1995 Porencephaly may result from either a developmental anomaly or an antepartum intraparenchymal insult. Pre- and postnatal ultrasonography can demonstrate characteristic images of porencephaly. There is minimal literature on diagnosis and outcome of antenata ... Full text Link to item Cite

Pregnancy complicated by Guillain-Barré syndrome.

Journal Article South Med J · September 1995 We report a case of a pregnant patient with Guillain-Barré syndrome. Her symptoms, including weakness, vague numbness, urinary incontinence, and unsteady gait, were initially mild and mimicked many of the changes seen in pregnancy. Her progressive weakness ... Full text Link to item Cite

Preconceptional counseling and intervention continued.

Journal Article Arch Intern Med · July 24, 1995 Link to item Cite

Cesarean delivery: a reconsideration of terminology.

Journal Article Obstet Gynecol · July 1995 The terminology we employ influences our perceptions. Thus, we believe in reviewing terminology regularly. The term "cesarean section" should be abandoned. A medical procedure is rarely named after a historic figure, and almost never after an ancient Roman ... Full text Link to item Cite

Bacterial vaginosis in pregnancy: an approach for the 1990s.

Journal Article Obstet Gynecol Surv · June 1995 It is proposed that clinicians screen all pregnant women at high risk for preterm labor and premature rupture of membranes for bacterial vaginosis, and treat all women when it is diagnosed. This infection is associated with a two to three times increase in ... Full text Link to item Cite

Successful treatment of a cervical pregnancy with a single low dose methotrexate regimen.

Journal Article Eur J Obstet Gynecol Reprod Biol · June 1995 Until very recently cervical pregnancies have been treated with surgery, usually hysterectomy. The development of endovaginal ultrasound, which allows early diagnosis, and methotrexate chemotherapy have opened up new therapeutic options. A 45-year-old mult ... Full text Link to item Cite

Porencephaly secondary to fetal trauma during amniocentesis.

Journal Article Obstet Gynecol · May 1995 BACKGROUND: There has been one reported case of porencephaly diagnosed postnatally as a result of amniocentesis. We report the first antenatal diagnosis of porencephaly, which apparently resulted from penetration of the fetal skull during amniocentesis. CA ... Full text Link to item Cite

Prenatal diagnosis and management of massive bilateral axillary cystic lymphangioma.

Journal Article Obstet Gynecol · May 1995 BACKGROUND: Fetal lymphangiomas can occur in many different anatomic locations, including the most commonly seen nuchal cystic hygroma. CASE: A fetus at 18 weeks' gestation was found to have a massive right axillary hygroma. The fetal karyotype was normal. ... Full text Link to item Cite

Anatomic changes in the pelvis after uncomplicated vaginal delivery: evaluation with serial MR imaging.

Journal Article Radiology · April 1995 PURPOSE: To demonstrate the normal involution process of the post-partum pelvis with serial magnetic resonance (MR) imaging. MATERIALS AND METHODS: MR imaging was performed in 14 women after uncomplicated vaginal delivery. Six women underwent serial MR exa ... Full text Link to item Cite

Non-immune hydrops after 20 weeks' gestation: review of 10 years' experience with suggestions for management.

Journal Article Obstet Gynecol · April 1995 OBJECTIVE: To analyze the etiologies and outcomes for a southeastern section of the United States, and to organize an efficient approach to evaluation. METHODS: We reviewed 82 cases of non-immune hydrops presenting after 20 weeks' gestation over a 10-year ... Full text Link to item Cite

Outcome of pregnancies with elevation of both maternal serum alpha-fetoprotein and human chorionic gonadotropin.

Journal Article Am J Perinatol · March 1995 We evaluated the pregnancy outcome of all patients with elevations of both maternal serum alpha-fetoprotein and human chorionic gonadotropin since institution of combined serum screening at our program. After analysis of 34,404 samples, 99 patients were fo ... Full text Link to item Cite

MISCARRIAGE - A HISTORICAL-PERSPECTIVE (VOL 21, PG 223, 1994)

Journal Article BIRTH-ISSUES IN PERINATAL CARE · March 1, 1995 Link to item Cite

In reply:

Journal Article Obstetrics and Gynecology · January 1, 1995 Full text Cite

Romano Ward syndrome in pregnancy

Journal Article Journal of Maternal-Fetal and Neonatal Medicine · January 1, 1995 Romano-Ward syndrome is an unusual and potentially devastating disorder manifested by prolongation of the QT interval. Persons with this syndrome are at risk for sudden death from ventricular dysrhythmis. A case of a gravid woman with the disorder is prese ... Full text Cite

Genetics for the obstetrician/gynecologist

Journal Article Primary Care Update for Ob/Gyns · January 1, 1995 Medical genetics is the most rapidly expanding field in medicine. The obstetrician/gynecologist frequently encounters patients with genetic issues that must be evaluated and may require consultation with a specialist. Commonly encountered problems include ... Full text Cite

Alpha1-antitrypsin deficiency and pregnancy

Journal Article American Journal of Perinatology · 1995 Alpha1-antitrypsin deficiency is an inherited pulmonary disorder which results from a deficiency of a major plasma protease inhibitor. The onset and severity of symptoms vary widely and depend on the genotype and whether the patient smokes cigarettes. Alph ... Cite

Miscarriage: a historical perspective.

Journal Article Birth · December 1994 Ancient cultures have applied a variety of fascinating therapies to prevent the occurrence and reoccurrence of miscarriage. Ceremonies of ritual purification, special prayers, and a variety of medicinal therapies were employed throughout the ages to preven ... Full text Link to item Cite

Obstetric damage and faecal incontinence.

Journal Article Lancet · November 19, 1994 Full text Link to item Cite

Prenatal diagnosis of renal agenesis in a twin gestation.

Journal Article Prenat Diagn · November 1994 Bilateral renal agenesis is a lethal congenital anomaly. It appears to be transmitted in a polygenic pattern. The prenatal ultrasound findings consist of severe oligohydramnios, absence of the fetal bladder, and failure to identify fetal kidneys. Twin gest ... Full text Link to item Cite

Recurrent miscarriage.

Journal Article Am J Perinatol · November 1994 The perinatologists are emerging as the physicians who evaluate and treat women with recurrent pregnancy loss. Recurrent miscarriage, previously referred to as habitual abortion, affects almost 1% of couples. The etiologies of recurrent miscarriage are div ... Full text Link to item Cite

Nonimmune hydrops fetalis secondary to premature closure of the foramen ovale.

Journal Article Am J Perinatol · November 1994 Premature closure of the foramen ovale is a rare cardiac anomaly. Severe right-sided heart failure accounts for the hepatomegaly, ascites, pleural and pericardial effusions, and generalized edema of these hydropic fetuses. Premature closure of the foramen ... Full text Link to item Cite

Preconceptional counseling and intervention.

Journal Article Arch Intern Med · October 24, 1994 Link to item Cite

Prenatal counseling in heterozygotes for ornithine transcarbamylase deficiency.

Journal Article Clin Pediatr (Phila) · September 1994 X-linked ornithine transcarbamylase deficiency (OTCD) often leads to fatal neonatal hyperammonemia in affected males (hemizygotes). In prenatal management of subsequent pregnancies, families carrying female fetuses are often reassured of the low risk of cl ... Full text Link to item Cite

A fetus with sirenomelia, omphalocele, and meningomyelocele, but normal kidneys.

Journal Article Teratology · August 1994 Sirenomelia, which has been reported for more than 450 years, is the most severe form of caudal dysplasia. This disorder is classically associated with agenesis or severe dysplasia of the urinary tract. A 27-year-old gravida 3 para 0020 presented at 19 wee ... Full text Link to item Cite

Nonimmune hydrops and hydrocephalus secondary to fetal intracranial hemorrhage.

Journal Article Am J Perinatol · July 1994 Our case demonstrates that nonimmune hydrops and hydrocephalus may be associated by the common pathway of intracranial hemorrhage and the development of anemia. The anemia apparently resulted in cardiomegaly with pericardial effusion and ascites as well as ... Full text Link to item Cite

Early postpartum endometritis. Randomized comparison of ampicillin/sulbactam vs. ampicillin, gentamicin and clindamycin.

Journal Article J Reprod Med · June 1994 Seventy-six parturients with a clinical diagnosis of early postpartum endometritis were randomized to be treated with either standard therapy--ampicillin, gentamicin and clindamycin--or a new regimen, ampicillin/sulbactam. We deliberately chose to administ ... Link to item Cite

Prenatal ultrasound findings of linear nevus sebaceous and its association with cystic adenomatoid malformation of the lung.

Journal Article Obstet Gynecol · May 1994 BACKGROUND: Nevus sebaceous is a congenital hamartomatous skin lesion that is commonly associated with other abnormalities and is most frequently located on the face and head. To our knowledge, there are no previous reports of the ultrasonographic appearan ... Link to item Cite

Neonatal complications after the administration of indomethacin for preterm labor

Journal Article Obstetrical and Gynecological Survey · January 1, 1994 Full text Cite

The frequency of transplacental hemorrhage in patients with threatened abortions.

Journal Article Gynecol Obstet Invest · 1994 The frequency and volume of transplacental hemorrhage that occurs with threatened abortions is unknown. The use of Rh immune globulin for such patients is therefore undefined. We studied the incidence and quantity of transplacental hemorrhage in patients w ... Full text Link to item Cite

Neonatal complications after the administration of indomethacin for preterm labor.

Journal Article N Engl J Med · November 25, 1993 BACKGROUND: The use of indomethacin as a tocolytic agent in pregnant women appears to be accompanied by a low incidence of neonatal complications. However, the neonatal effects of indomethacin have been studied primarily in infants born after 32 weeks' ges ... Full text Link to item Cite

Facial features of infants exposed prenatally to cocaine.

Journal Article Teratology · November 1993 Thirty two infants referred for in-patient genetics evaluation at the University of California at San Francisco, 1987-1992, were found to have a history of maternal cocaine use. Genetics reports and medical records were reviewed on all these infants to ide ... Full text Link to item Cite

Fetal metatarsal length: an accurate predictor of gestational age and weight in the ovine fetus.

Journal Article Gynecol Obstet Invest · 1993 Accurate assessment of gestational age and fetal weight in the pregnant ewe is important in both acute and longitudinal perinatal studies. We describe two morphometric methods based on the length of the fetal metatarsal bone. These measurements can be made ... Full text Link to item Cite

Outcome of antenatally diagnosed cystic adenomatoid malformations.

Conference Am J Obstet Gynecol · October 1992 OBJECTIVE: Twenty-two cases of antenatally diagnosed congenital cystic adenomatoid malformations are reported. STUDY DESIGN: Case management is reviewed. RESULTS: Eighteen women continued pregnancy after diagnosis. In nine cases nonimmune hydrops fetalis d ... Full text Link to item Cite

Diminution in size of a fetal intrathoracic mass: caution against aggressive in utero management.

Journal Article Am J Perinatol · July 1992 Space-occupying lesions within the fetal thorax are associated with poor perinatal outcome. Therefore some investigators have suggested in utero treatment. We describe a case of a fetus with a large intrathoracic mass that was noted to decrease markedly in ... Full text Link to item Cite

Pallister-Hall syndrome associated with an unbalanced chromosome translocation.

Journal Article Am J Med Genet · June 1, 1992 We report 3 cases of Pallister-Hall syndrome involving hypothalamic hamartoblastoma, hypopituitarism, cranial, and limb abnormalities. The first 2 cases represent the first apparent sibs reported with this syndrome. Patient 1 represents the first known pat ... Full text Link to item Cite

Pregnancy complicated by Goodpasture syndrome.

Journal Article Obstet Gynecol · May 1992 Goodpasture syndrome is characterized by pulmonary hemorrhage, glomerulonephritis, and an autoantibody to glomerular basement membrane antigens. Current management of this potentially lethal disease consists of glucocorticoids to control pulmonary hemorrha ... Link to item Cite

Prenatal diagnosis of Duchenne muscular dystrophy by fetal muscle biopsy.

Journal Article Hum Genet · 1992 Prenatal diagnosis and carrier detection for Duchenne muscular dystrophy (DMD) usually can be performed using DNA analysis. When recombination occurs within the DMD gene, or DNA analysis is uninformative, or in pedigrees where it is unclear whether or not ... Full text Link to item Cite

PRENATAL-DIAGNOSIS OF DUCHENNE MUSCULAR-DYSTROPHY BY FETAL MUSCLE BIOPSY

Journal Article AMERICAN JOURNAL OF HUMAN GENETICS · October 1, 1991 Link to item Cite

Unusual presentations of fetal teratoma.

Journal Article J Perinatol · September 1991 Teratomas are the most common congenital neoplasm. Fetal intracranial teratomas generally are large solid/cystic tumors that often completely replace normal brain tissue. Mediastinal teratomas are uncommon and rarely result in nonimmune hydrops fetalis. We ... Link to item Cite

Efficacy of hepatitis B screening in a private obstetrical population.

Journal Article J Perinatol · June 1991 We sought to determine whether the recent Centers for Disease Control recommendation of universal prenatal screening for hepatitis B surface antigen (HBsAg) is necessary or cost-effective in a population of private patients. During the 21 months of our stu ... Link to item Cite

In utero intravascular transfusion for treating fetal hemolytic disease.

Journal Article Surg Gynecol Obstet · April 1991 Technologic advances in ultrasound have led to the ability to access the fetal circulation in utero. Precise evaluation and accurate treatment of fetal hemolytic disease is now possible. This technique of in utero intravascular transfusion has several adva ... Link to item Cite

Rh immune globulin prophylaxis for threatened abortions.

Journal Article Am J Obstet Gynecol · February 1991 Full text Link to item Cite

Trisomy 15 associated with nonimmune hydrops.

Journal Article Am J Perinatol · January 1991 Full text Link to item Cite

Rapid assessment of fetal hemoglobin concentration with the HemoCue system.

Journal Article Obstet Gynecol · October 1990 Successful treatment of severe fetal hemolytic disease depends on rapid and accurate measurement of fetal hemoglobin or hematocrit. The HemoCue is a portable hemoglobinometer that rapidly measures hemoglobin concentration. To evaluate the potential role of ... Link to item Cite

Hypokalemia associated with hyperparathyroidism in pregnancy.

Journal Article Am J Perinatol · July 1990 A case of hyperparathyroidism complicating pregnancy is described. An uncommon associated finding of hypokalemia and its possible etiology is discussed. When hypokalemia occurs in the setting of hyperparathyroidism, oral phosphates should be used with caut ... Full text Link to item Cite

Vulvar leiomyosarcoma in pregnancy.

Journal Article Am J Obstet Gynecol · January 1990 To our knowledge, this is the first case of vulvar leiomyosarcoma occurring during pregnancy to be reported. The neoplasm was resected immediately after a term vaginal delivery. A wide local excision of the vulva with bilateral superficial inguinal node sa ... Full text Link to item Cite

Obstetric management of a fetus with nonlethal osteogenesis imperfecta.

Journal Article Obstet Gynecol · September 1988 Osteogenesis imperfecta is the common term for a heterogeneous group of heritable disorders of connective tissue with lethal and nonlethal forms. Prenatal diagnosis presents difficult medical and ethical issues. Of concern are the following: 1) the certain ... Link to item Cite