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A O Odibo

Publications and source records attributed to A O Odibo.

9 recordsLinked to original sources
PubMed2002

Prediction of preterm premature rupture of membranes by transvaginal ultrasound features and risk factors in a high-risk population.

OBJECTIVE: To determine the transvaginal ultrasound features and risk factors that predict preterm delivery (PTD) preceded by either preterm premature rupture of membranes (PPROM) or preterm labor (PTL) in a high-risk population. STUDY DESIGN: Singleton gestations at high-risk for preterm delivery were screened prospectively with transvaginal ultrasound between 14 and 24 weeks. Univariate and multivariate regression analyses were performed for historical obstetric risk factors and transvaginal ultrasound features (cervical length (CL) and cervical funneling (CF)) for the prediction of PTD preceded by PPROM or PTL at < 32 and < 35 weeks' gestation, respectively. Indicated preterm deliveries were excluded. RESULTS: Of 321 patients screened, 71 (22%) delivered at < 35 weeks, 40 (56%) after PPROM and 31 (44%) after PTL. Preterm delivery at < 32 weeks was seen in 47 patients (15%), with 20 (43%) occurring after PTL and 27 (57%) after PPROM. Univariate analysis showed the following to be significant predictors of PPROM at < 35 weeks: a past history of PTD between 25 and 30 weeks (P < 0.008), cerclage in the current pregnancy (P < 0.0001), bacterial vaginosis (P < 0.011), CL < 25 mm (P < 0.0001) and CF > 25% (P < 0.0001). The following were found to be significant predictors of PTL at < 35 weeks: black race (P < 0.02), a cerclage in the current pregnancy (P < 0.01), CL < 25 mm (P < 0.001) and CF > 25% (P < 0.0001). The significant predictors of PPROM at < 32 weeks were cerclage in the current pregnancy (P < 0.006) and CL < 25 mm (P < 0.0001); for PTL at < 32 weeks they were a past history of spontaneous miscarriage between 14 and 24 weeks (P < 0.02), black race (P < 0.021), cerclage in the current pregnancy (P < 0.001) and CL < 25 mm (P < 0.001). Multivariate regression analysis revealed the significant predictors of PPROM at < 35 weeks to be: a history of PTD between 25 and 30 weeks with odds ratio (OR) 4.8 (95% confidence interval (CI), 1.9-11.5) and CL < 25 mm with OR 7.9 (95% CI, 3.6-17.5). The significant predictors of PTL at < 35 weeks on multivariate regression were black race with OR 2.2 (95% CI, 1.0-4.8) and unemployment with OR 1.2 (95% CI, 1.0-1.5). For deliveries < 32 weeks, CL < 25 mm (OR, 10.1; 95% CI, 3.2-32) was the only significant predictor of PPROM. Significant predictors of PTL were unemployment (OR, 1.3; 95% CI, 1.1-1.7), a history of spontaneous miscarriage between 14 and 24 weeks (OR, 6.2; 95% CI, 1.4-25), black race (OR, 8.6; 95% CI, 1.5-47) and CL < 25 mm (OR, 4.4; 95% CI, 1-19). The sensitivity, specificity and positive and negative predictive values of CL < 25 mm for PPROM at < 35 weeks were 73%, 69%, 25% and 95%, respectively; for PTL at < 35 weeks they were 58%, 66%, 15% and 94%; for PPROM at < 32 weeks they were 85%, 68%, 20%, and 98%; for PTL at < 32 weeks they were 70%, 66%, 12% and 97%. CONCLUSION: There are differences in both transvaginal ultrasound findings and risk factors that predict PPROM or PTL. Of the pathways leading to PTD, CL was a more significant predictor of PPROM compared with PTL, while sociodemographic factors were more predictive of PTL.

Adult↗
PubMed2001

Does transvaginal ultrasound of the cervix predict preterm premature rupture of membranes in a high-risk population?

OBJECTIVES: To determine in patients with a cervical length < 25 mm on transvaginal ultrasound if the severity of cervical length shortening can be used to predict preterm premature rupture of membranes (PPROM) and the contribution of PPROM to preterm delivery in these patients. METHODS: We retrospectively reviewed asymptomatic singleton pregnancies between 14 and 24 weeks at high risk of preterm delivery by obstetric history and transvaginal cervical length < 25 mm. Cases developing subsequent PPROM were compared with controls for transvaginal sonographic cervical characteristics. RESULTS: Of 69 patients identified to have a cervical length < 25 mm, 27 (39%) had PPROM, and 42 (61%) did not. Mean +/- standard deviation (SD) cervical length was 12.7 +/- 8.7 mm and 17.0 +/- 7.6 mm in the two groups, respectively (P = 0.04). Mean +/- SD cervical funneling was 57.4 +/- 31.4% and 40.0 +/- 28.1%, respectively (P = 0.01). The characteristics most predictive of PPROM were: cervical length of < 10 mm (sensitivity, specificity, positive and negative predictive values of 33, 90, 69, and 68%, respectively; odds ratio, 4.8; 95% confidence interval, 1.3-17.5) and cervical funneling > 75% (sensitivity, specificity, positive and negative predictive values of 33, 93, 75 and 68%, respectively; odds ratio, 6.5; 95% confidence interval, 1.6-26.9). Stepwise logistic regression revealed cervical length to be a significant predictor of PPROM (odds ratio, 4.0; 95% confidence interval, 1.1-14.2). CONCLUSION: In patients at high risk for preterm delivery because of obstetric history and transvaginal sonographic cervical length < 25 mm, a cervical length < 10 mm and cervical funneling > 75% were most predictive of PPROM. PPROM was the major contributor to preterm delivery in these patients.

Adult↗
PubMed1999

Relationship of amniotic fluid markers of intra-amniotic infection with histopathology in cases of preterm labor with intact membranes.

OBJECTIVE: To evaluate the correlation of amniotic fluid (AF) markers (AFMs) of intra-amniotic infection with histopathologic findings in cases of preterm labor with intact membranes, between 22 and 36 weeks' gestation. STUDY DESIGN: We reviewed the charts of patients admitted in preterm labor with intact membranes between January 1993 and December 1996. Those having amniocentesis were identified, and AFMs were compared with histopathology in patients who delivered within 48 hours of the amniocentesis. The AFMs evaluated were glucose, polymorphonuclear leukocytes, Gram stain, and culture. All placentae were reviewed by a single pathologist blinded to the AF findings. Histologic evidence of acute inflammation was defined by findings of both subchorial intervillositis and marginating choriodeciduitis. The sensitivities, specificities, and positive and negative predictive values of the various AFMs were calculated. RESULTS: Of 556 women with intact membranes presenting in preterm labor, 181 (32.6%) had amniocentesis and 88 delivered within 48 hours of the amniocentesis. Histopathologic chorioamnionitis was seen in 53 patients (60.2%). The findings (with their sensitivity, specificity, and positive and negative predictive values) were: polymorphonuclear leukocytes at > 10/high-power field (22.6%, 97.2%, 92.3%, and 46.1%), positive Gram stain (26.4%, 94.6%, 87.5%, and 47.3%), culture (28.3%, 92.1%, 83.3%, and 47.9%), and glucose of < 15 mg/dl (28.3%, 94.6%, 88.2%, and 47.9%), respectively. Using a receiver-operator characteristic curve for different level of AF glucose, a glucose level of < 20 mg/dl was the most sensitive AF predictor of histologic chorioamnionitis. CONCLUSION: Histopathologic evidence of chorioamnionitis was present in 60.2% of cases of preterm births due to preterm labor in women who at our institution were offered and accepted amniocentesis and subsequently delivered within 48 hours. AFMs may be useful predictors of histologic chorioamnionitis. The most efficient AFM for chorioamnionitis in this group of patients was glucose at < 20 mg/dl.

Adult↗
PubMed1998

Management of parvovirus infection in pregnancy and outcomes of hydrops: a survey of members of the Society of Perinatal Obstetricians.

OBJECTIVE: Our purpose was to investigate the evaluation and management of parvovirus infection during pregnancy. STUDY DESIGN: Surveys were mailed to members of the Society of Perinatal Obstetricians residing in the United States and Canada in July 1997. They were asked about their evaluation and management of parvovirus infection, including whether they repeated and confirmed serologic studies, what their initial and follow-up evaluations included, whether they had had any cases of parvovirus-associated hydrops in the past 2 years, and if so, what were the management and outcomes of the hydropic fetuses. RESULTS: Surveys were mailed to 1623 members of the Society of Perinatal Obstetricians and 541 completed surveys were returned. Sixty-eight percent of the respondents repeated and confirmed serologic studies. Eighty-nine percent used ultrasonography in their initial management of pregnant patients with recent parvovirus infection, 7.5% used amniocentesis for polymerase chain reaction, and 2% used fetal blood sampling. The outcomes of the 539 cases of parvovirus-induced hydrops included spontaneous resolution in 34%, death without intrauterine transfusion in 30%, resolution after intrauterine transfusion in 29%, death after intrauterine transfusion in 6%, and pregnancy termination in 1%. Almost all cases of nonimmune hydrops reported occurred between 16 and 32 weeks. CONCLUSIONS: Approximately one third of the cases of parvovirus-induced nonimmune hydrops resolved spontaneously, whereas 83.5% of hydropic fetuses transfused survived.

Amniocentesis↗
PubMed1998

Resolution of human parvovirus B19-induced nonimmune hydrops after intrauterine transfusion.

Our objective is to report our experience with cases of prolonged recovery from nonimmune hydrops secondary to human parvovirus B19 infection occurring after intrauterine transfusion. We reviewed cases referred to our unit over a 10 year period for exposure to parvovirus B19 infection. Those cases with serologic evidence of recent infection were identified. The cases requiring intrauterine transfusion were reviewed for demographic details, time of exposure, parvovirus B19 serology, gestational age at detection of nonimmune hydrops, number and results of fetal blood samples, duration from intrauterine transfusion to resolution of hydrops, and neonatal outcome. Of 38 cases identified through serologic evidence of recent parvovirus B19 infection, 35 (92.1%) did not develop hydrops, and these were followed by serial ultrasonography for 8 weeks from the time of exposure. Three cases (7.9%) developed hydrops and required intrauterine transfusion; in two the transfusion was intravascular and in one it was intraperitoneal. The mean duration from intrauterine transfusion to resolution of hydrops was 8 weeks 2 days. Pregnancy outcome in all cases was normal. In cases of nonimmune hydrops secondary to parvovirus B19 infection, resolution of the hydrops after intrauterine transfusion may take up to 12 weeks with a normal pregnancy outcome.

Adult↗