Biomedical subjects

Anthony Odibo

Publications and source records attributed to Anthony Odibo.

3 recordsLinked to original sources

PubMed2006

Can uterine rupture in patients attempting vaginal birth after cesarean delivery be predicted?

OBJECTIVE: This study was undertaken to use multivariable methods to develop clinical predictive models for the occurrence of uterine rupture by using both antepartum and early intrapartum factors. STUDY DESIGN: This was a planned secondary analysis from a multicenter case-control study of uterine rupture among women attempting vaginal birth after cesarean (VBAC) delivery. Multivariable methods were used to develop 2 separate clinical predictive indices--one that used only prelabor factors and the other that used both prelabor and early labor factors. These indices were also assessed with the use of Receiver operating characteristic curves. RESULTS: We identified 134 cases of uterine rupture and 665 noncases. No single individual factor is sufficiently sensitive or specific for clinical prediction of uterine rupture. Likewise, the 2 clinical predictive indices were neither sufficiently sensitive nor specific for clinical use (receiver operating characteristic curve [area under the curve] 0.67 and 0.70, respectively). CONCLUSION: Uterine rupture cannot be predicted with either individual or combinations of clinical factors. This has important clinical and medical-legal implications.

Adult↗

PubMed2005

Maternal complications with vaginal birth after cesarean delivery: a multicenter study.

OBJECTIVE: This study was undertaken to determine incidence and risk factors for uterine rupture in women attempting vaginal birth after cesarean delivery (VBAC) in a wide range of hospital settings. STUDY DESIGN: We performed a case-control study nested within a cohort of women who have had a prior cesarean to determine the incidence and risk factors for uterine rupture in women attempting VBAC. RESULTS: The incidence rate of uterine rupture in those who attempt VBAC was 9.8 per 1000. A prior vaginal delivery was associated with a lower risk of uterine rupture (adjusted odds ratio [OR] = 0.40, 95% CI 0.20-0.81). Although prostaglandins alone were not associated with uterine rupture, sequential use of prostaglandin and pitocin was associated with uterine rupture (adjusted OR = 3.07, 95% CI 0.98-9.88). CONCLUSION: Women with a prior cesarean should be offered VBAC, and women with a prior cesarean and prior vaginal delivery should be encouraged to VBAC. Although other studies have suggested that prostaglandins should be avoided, we suggest that inductions requiring sequential agents be avoided.

Adult↗

PubMed2005

First trimester screening: economic implications.

The implementation of new strategies for the detection of Down syndrome will have economic implications. These economic considerations must be considered before implementation, since resources are limited and health care costs in the Unites States are soaring. Economic analyses of prenatal diagnosis have unique challenges that must be considered. Most analyses include only direct medical costs, ignoring indirect and intangible costs.

Adult↗