Individual treatment of integrated silver yoga system boosts aerobic guidelines inside older persons

BACKGROUND A furcate placental cord insertion is rare and potentially dangerous. Prenatal diagnosis of this finding has been reported on only two prior occasions. CASE We present the case of a 33-year-old patient who, at 35 weeks of gestation, was suspected on ultrasonography to have a cord insertion that was both furcate and velamentous. Because of this finding, the patient underwent labor induction at 37 weeks of gestation and delivered a vigorous neonate vaginally. Pathologic evaluation confirmed furcate placenta. CONCLUSION The identification of a furcate placenta, a potentially lethal umbilical cord insertion site abnormality, is possible prenatally. Future research should elucidate the prevalence of furcate cord insertions as well as whether they impose increased fetal risk.OBJECTIVE To describe factors associated with not being tested for Chlamydia trachomatis and Neisseria gonorrhea infection during pregnancy and for testing positive and to describe patterns of treatment and tests of reinfection. VX-765 METHODS We conducted a retrospective cohort study of women who delivered at an urban teaching hospital from July 1, 2016 to June 30, 2018. Women with at least one prenatal care or triage visit were included. The index delivery was included for women with multiple deliveries. We used logistic regression to analyze factors associated with not being tested and for testing positive for these infections in pregnancy. Cox proportional hazards models were used to examine factors associated with time to treatment and tests of reinfection. We reviewed medical records to determine reasons for delays in treatment longer than 1 week. RESULTS Among 3,265 eligible deliveries, 3,177 (97%) women were tested during pregnancy. Of these, 370 (12%) tested positive (287 chlamydia, 35 gonorrhea, 48 both), and 15% had repeat infections. Prenatal care adequacy and insurance status were risk factors for not being tested. Age, race and ethnicity, alcohol use, and sexually transmitted infection history were associated with testing positive. Time to treatment ranged from 0 to 221 days, with the majority (55%) of patients experiencing delays of more than 1 week. Common reasons for delays included lack of clinician recognition and follow-up of abnormal results (65%) and difficulty contacting the patient (33%). CONCLUSION Traditional risk factors are associated with increased risk of infection during pregnancy. Prenatal care adequacy and insurance status were associated with the likelihood of being tested. Delays in treatment and tests of reinfection were common. Point-of-care testing and expedited partner therapy should be explored as ways to improve the management of these infections in pregnancy.OBJECTIVE To describe the prevalence of hepatitis C virus (HCV) antibody, evaluate current risk factors associated with HCV antibody positivity, and identify novel composite risk factors for identification of groups most likely to demonstrate HCV antibody seropositivity in an obstetric population from 2012 to 2015. METHODS The Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network initiated an observational study of mother-to-child transmission of HCV in 2012 that included offering HCV antibody screening to their entire obstetric population. Women presenting for prenatal care before 23 weeks of gestation without a known multifetal gestation were eligible. For each woman who was HCV antibody-positive, two women at similar gestational age who were HCV antibody-negative were identified and included for comparison. Risk factors were evaluated by patient interview and chart review. Women in the case group were identified to have a signal-to-cutoff valuuseful in defining new strategies for identifying mothers with the HCV antibody and the neonates susceptible to maternal transmission of HCV. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, NCT01959321.It has long been observed that neonates born between 39 and 40 gestational weeks have the best perinatal outcomes. What has not been known, until recently, is whether these ideal perinatal outcomes would be achieved in neonates whose delivery was brought on intentionally in this window by labor induction. Recent randomized trials and large observational cohorts have answered this question labor induction, as compared with expectant management, lowers the rate of cesarean delivery (without increasing other adverse maternal outcomes) and improves perinatal outcomes. For those women still pregnant, delivery at 39 weeks of gestation would simultaneously lower the number of cesarean deliveries and reduce the number of stillbirths and neonatal deaths in the United States.Resident well-being is a significant issue affecting our future physicians' abilities to fulfill their potential in training and practice. In the 2017 Council on Resident Education in Obstetrics and Gynecology National Wellness Survey, residents identified many challenges to wellness and had the opportunity to provide free-text responses about these issues. Secondary analysis of these responses revealed clusters of symptoms associated with mood disorders, including high rates of reported anxiety and depression symptoms, and even suicidality. The prevalence of these self-reported symptoms underscores the importance of targeting wellness programming efforts, improving health care work environments, advancing access to care, and destigmatizing mental health concerns for our learners.OBJECTIVE To assess whether racial and ethnic disparities in adverse infant and maternal outcomes exist among low-risk term pregnancies. METHODS This population-based retrospective cohort study used U.S. vital statistics data from 2014 to 2017. Women with low-risk, nonanomalous singleton pregnancies who labored and delivered at 37-41 weeks of gestation were included and categorized by maternal race and ethnicity non-Hispanic white (white), non-Hispanic black (black), Hispanic, and non-Hispanic Asian (Asian). Multivariable Poisson regression models were used to estimate the associations of composite neonatal adverse outcome (Apgar score less than 5 at 5 minutes, assisted ventilation for more than 6 hours, neonatal seizure, or neonatal death), infant mortality, and composite maternal adverse outcome (blood transfusion, admission to the intensive care unit, uterine rupture, or unplanned hysterectomy) with maternal race and ethnicity. RESULTS Of 9,205,873 women included, 55.5% were white, 13.7% were black, 24.3% were Hispanic, and 6.