Biomedical subjects

Anthony O Odibo

Publications and source records attributed to Anthony O Odibo.

25 records · Page 2Linked to original sources

PubMed2003

Mild pyelectasis: evaluating the relationship between gestational age and renal pelvic anterior-posterior diameter.

OBJECTIVE: To determine the relationship between gestational age and renal pelvic anterior-posterior diameter and the feasibility of developing gestational age-specific thresholds for the diagnosis of mild pyelectasis. METHODS: Cross-sectional study of 420 singleton fetuses between 16 and 39 weeks' gestation. The mean renal AP diameter as a function of gestational age was determined using fractional polynomial regression models and centile plots were generated. Assessment of goodness of fit for each regression model was performed. RESULTS: There was a positive correlation between gestational age and renal pelvic AP diameter (Pearson's Correlation Coefficient 0.65). Using the derived mean and standard deviations of renal AP diameter, gestational-age specific 95% reference levels were generated. The sensitivity, specificity, positive, and negative predictive values of using the gestational age-specific cutoffs for predicting persistent postnatal renal anomaly were 80%; 99%; 29%; and 99% respectively. CONCLUSION: There is a positive correlation between gestational age and renal pelvic AP diameters. Reliable gestational age-specific renal AP thresholds for diagnosis of pyelectasis are provided.

Cross-Sectional Studies↗

PubMed2003

Development of a scoring system for predicting the risk of preterm birth in women receiving cervical cerclage.

OBJECTIVE: To develop a model for identifying women receiving cervical cerclage at risk for spontaneous preterm birth <32 weeks. STUDY DESIGN: Retrospective cohort study of high-risk patients based on past obstetric history. Our inclusion criteria involved all patients with singleton gestation who received cerclage between 10 and 24 weeks. They were evaluated for the risk factors associated with preterm birth <32 weeks. Risk factors evaluated include: indication for cerclage, gestational age at cerclage placement, cervical length prior to cerclage, timing of cerclage (emergency or elective) and route of cerclage (abdominal or vaginal). Univariable and multivariable analyses were used to determine the risk factors associated with preterm birth. A risk-scoring model was developed for the prediction of preterm birth <32 weeks in women receiving cerclage. RESULTS: We identified 256 women receiving cerclage that met our inclusion criteria. Preterm births <32 weeks occurred in 51 (20%). Multivariable analysis revealed a cervical length <25 mm, a history of cone biopsy and emergency cerclage to be significant risk factors associated with preterm birth <32 weeks. The sensitivity, specificity, positive and negative predictive values of the best model for predicting spontaneous preterm birth <32 weeks in women with cerclage are 80%; 96%; 82% and 95%, respectively. CONCLUSION: The presence of a short cervical length, a history of cone biopsy and emergency cerclage were associated with preterm birth <32 weeks. Our model had a high sensitivity for identifying women who may benefit from a closer surveillance.

Adult↗

PubMed2003

Current concepts regarding vaginal birth after cesarean delivery.

PURPOSE OF REVIEW: To review the current literature on vaginal birth after cesarean delivery efficacy and safety. RECENT FINDINGS: There are two major themes in current vaginal birth after cesarean delivery research. The first is continued work on the short-term safety, including maternal events such as uterine rupture and perinatal death. The second theme focuses on identifying predictors for success and failure. SUMMARY: Current information suggests that the rate of major maternal and neonatal complications with vaginal birth after cesarean delivery is low, and this option should be offered to women with a single prior low transverse cesarean. Future research should focus on an evaluation of both short-term and long-term consequences of vaginal birth after cesarean delivery compared with elective repeat cesarean section.

Female↗

PubMed2003

Prevention of preterm birth by cervical cerclage compared with expectant management: a systematic review.

UNLABELLED: Our objective was to review the evidence on the use of cervical cerclage to prevent preterm births compared with expectant management. An OVID, MEDLINE, Cochrane Database, and Science Citation Index search using the medical subject headings and terms "cervical cerclage," "cervical incompetence" and "preterm delivery" was conducted for the period 1966 to 2002. We included all randomized trials that evaluated the effectiveness of cervical cerclage in preventing preterm birth. Using a standardized data collection instrument, we reviewed trial designs, inclusion and exclusion criteria, and maternal and neonatal outcome. Fixed or random effects model were used to pool both dichotomous and continuous outcomes where appropriate. Seven trials were identified; six met our inclusion criteria. A total of 2190 women enrolled into the trials were identified with 1110 receiving cerclage and 1080 managed expectantly. There were a total of 278 of 2190 (12.7%) deliveries before 34 weeks of gestation. The meta-analysis demonstrated a trend toward cervical cerclage preventing preterm delivery at less than 34 weeks (OR 0.77, 95% CI, 0.59, 0.99; P =.049). However, there was no demonstrable improvement in neonatal mortality (OR of 0.0.86, 95% CI, 0.56, 1.33; P =.50). There is a trend toward cervical cerclage reducing preterm births before 34 weeks. The use of cerclage is, however, associated with an increased risk of postpartum fever. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES: After completion of this article, the reader will be able to compare the evidence on the use of cervical cerclage with preventing preterm births and to criticize the various articles evaluating the use of cervical cerclage.

Cerclage, Cervical↗

PubMed2003

Screening for aneuploidy in twins and higher-order multiples: is first-trimester nuchal translucency the solution?

UNLABELLED: Screening for aneuploidy in twins and higher-order multiples present complex practical and ethical issues that limit its provision to women. We review the currently available screening options and compare the merits and disadvantages of each method. The available diagnostic tests and therapeutic interventions for screen positive cases are also reviewed. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES: After completion of this article, the reader will be able to list the various screenings for Down syndrome during pregnancy, to outline the advantages and disadvantages of each screening method, and to summarize the challenges in screening for aneuploidy in twins.

Aneuploidy↗

PubMed2003

Screening for aneuploidy in twin pregnancies: maternal age- and race-specific risk assessment between 9-14 weeks.

The aim of this study was to calculate the risk for aneuploidy in twin pregnancies between 9-14 weeks utilizing maternal age, race and dizygotic twinning rates. Using previously published risks for aneuploidy in singletons and twins at the time of amniocentesis and at term, we calculated new risk estimates for twins at 9-14 weeks gestation or at the time of chorionic villus sampling. Using these tables, the risk for trisomy 21 in at least one fetus of a twin gestation in a 32-year-old at 9-14 weeks is 1/285 for Whites and for African-Americans. This is equivalent to the risk for trisomy 21 (1/265) in a 35-year-old woman with a singleton at the same gestational age. The risks for trisomies 18 and 13 also follow similar trends. In counseling women with twin pregnancies at the time of first trimester nuchal translucency screening or chorionic villus sampling, it should be noted that the maternal age-related risk for aneuploidy for a 32-year-old is equivalent to that of a 35-year-old woman with a singleton gestation.

Aneuploidy↗

PubMed2002

Management of twin-twin transfusion syndrome: laying the foundation for future interventional studies.

Twin-twin transfusion syndrome is the most common complication of monochorionic pregnancies affecting between 5 and 15% of such pregnancies and accounts for 15-77% of perinatal mortality in twins. The management of twin-twin transfusion syndrome is complex and various treatment modalities have been tried. This review critically evaluates the different management options available for the syndrome and recommends some guidelines for future interventional studies.

Female↗