A5000338718- Maternal and fetal healthcare
- Pregnancy and preeclampsia studies
- Maternal and Perinatal Health Interventions
- Neonatal Respiratory Health Research
- Assisted Reproductive Technology and Twin Pregnancy
- Neonatal and fetal brain pathology
- Fetal and Pediatric Neurological Disorders
- COVID-19 Impact on Reproduction
- Preterm Birth and Chorioamnionitis
- Prenatal Screening and Diagnostics
- Gestational Diabetes Research and Management
- Pregnancy-related medical research
- MRI in cancer diagnosis
- Global Maternal and Child Health
- Congenital Anomalies and Fetal Surgery
- Cardiovascular Issues in Pregnancy
- Neuroscience of respiration and sleep
- Healthcare Systems and Practices
- Pelvic floor disorders treatments
- Ectopic Pregnancy Diagnosis and Management
- Occupational Health and Performance
- Birth, Development, and Health
- Blood Coagulation and Thrombosis Mechanisms
- Anesthesia and Pain Management
- Advanced Causal Inference Techniques
Harvard University
2009-2024
Massachusetts General Hospital
2015-2024
Society for Maternal-Fetal Medicine
2023
Community Link
2020
Brigham and Women's Hospital
1991-2020
Massachusetts Institute of Technology
2019
Island Institute
2019
Wilford Hall Ambulatory Surgical Center
1994-2015
Harvard University Press
2005
Texas Biomedical Research Institute
2005
In Brief Persistent occiput posterior (OP) is associated with increased rates of maternal and newborn morbidity. Its diagnosis by physical examination challenging but improved bedside ultrasonography. Occiput discovered in the active phase or early second stage labor usually resolves spontaneously. When it does not, prophylactic manual rotation may decrease persistent OP its complications. delivery indicated for arrest descent setting OP, a pragmatic approach suggested. Suspected fetal...
BACKGROUND: Rescue therapies to treat or prevent progression of coronavirus disease 2019 (COVID-19) hypoxic respiratory failure in pregnant patients are lacking. METHOD: To meeting criteria for severe critical COVID-19 with high-dose (160–200 ppm) nitric oxide by mask twice daily and report on their clinical response. EXPERIENCE: Six were admitted at Massachusetts General Hospital from April June 2020 received inhalational therapy. All tested positive acute syndrome 2 (SARS-CoV-2) infection....
In Brief OBJECTIVE: To analyze the effect of gestational age, delivery mode, and maternal–fetal risk factors on rates respiratory problems among infants born 34 or more weeks gestation over a 9-year period. METHODS: Retrospective analysis prospectively collected maternal neonatal data all inborn births at single tertiary care center for years 1990–1998. Specific diagnostic criteria were concurrently applied by investigator. RESULTS: Over period, late-preterm increased 37%, whereas than 40...
Abstract Fetal health is critically dependent on placental function, especially transport of oxygen from mother to fetus. When fetal growth compromised, insufficiency must be distinguished modest genetic potential. If present, the physician trade off risk prolonged exposure against risks preterm delivery. Current ultrasound methods evaluate placenta are indirect and insensitive. We propose use Blood-Oxygenation-Level-Dependent (BOLD) MRI with maternal hyperoxia quantitatively assess mismatch...
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OBJECTIVE: To evaluate whether the use of inhaled nitric oxide (iNO) 200 improves respiratory function. METHODS: This retrospective cohort study used data from pregnant patients hospitalized with severe bilateral coronavirus disease 2019 (COVID-19) pneumonia at four teaching hospitals between March 2020 and December 2021. Two cohorts were identified: 1) those receiving standard care alone (SoC cohort) 2) iNO for 30 minutes twice daily in addition to (iNO cohort). Inhaled oxide, as a novel...
The US cesarean delivery rate remains 30%-32%. Increases in maternal age, obesity, and diabetes put upward pressure on this rate. Alternatives to delivery, vaginal birth after (VBAC), operative are underutilized there substantial challenges their resurgence. Practice guidelines offer promise, but demonstrate only minor reductions delivery. We estimate that the overall will remain 27%-30% for immediate future. As more states move recognize independent practice of midwifery payers seek lower...
To evaluate whether a liposomal bupivacaine incisional block decreases postoperative pain and represents an opioid-minimizing strategy after scheduled cesarean delivery.In single-blind, randomized controlled trial among opioid-naive women undergoing delivery, or placebo was infiltrated into the fascia skin at surgical site, before fascial closure. Using 11-point numeric rating scale, primary outcome score with movement 48 hours postoperatively. A sample size of 40 per group needed to detect...
The objective of the study was to estimate risks third-trimester amniocentesis with continuous ultrasound guidance.Cohort study. We reviewed medical records women who had an guidance after 30 weeks' gestation at a single institution from January 1991 through December 1994. For procedures performed February 1994, we obtained information chart review. From March 1994 collected data prospectively. primary outcome whether or not there were any complications within 48 hours procedure. also sought...
In Brief OBJECTIVE To describe changes in neonatal and obstetric practices that may have contributed to the decreasing incidence of meconium aspiration syndrome our population during this time. METHODS We compared characteristics 61 infants diagnosed with 1365 born through moderate or thick meconium-stained amniotic fluid at more than 37 weeks' completed gestation. Data were prospectively collected, all respiratory diagnoses concurrently made. Three distinct birth year groups analyzed based...
To identify characteristics associated with high inpatient daily opioid consumption after cesarean delivery.This is a retrospective cohort study of all deliveries performed under neuraxial anesthesia morphine, at single institution from January 1, 2015, to December 31, 2015. Women preoperative use disorder or chronic were excluded. Sociodemographic data, medical comorbidities, anxiolytics antidepressants, smoking history, nonopioid substance use, intrapartum and delivery characteristics,...
Abstract The transformation of our health care system in response to coronavirus disease 2019 (COVID-19) provides a unique opportunity examine the use telehealth for postpartum care. period can pose significant risks and challenges, particularly women with hypertensive disorders pregnancy. Remote blood pressure monitoring has proven feasible acceptable among providers but not been widely implemented or researched. Early studies have identified improved outcomes telehealth, including...
Abstract The objective was to correlate Doppler indices from the uterine arcuate arteries with an analysis of decidual vascular histology in patients type I diabetes. Pulsed wave used sample artery system beneath placenta within 8 days delivery 47 diabetes mellitus. A placental pathologist, without knowledge either clinical outcome or information, classified histological appearance as normal, (hyalinization, mural thickening), B (fibrinoid necrosis, atherosis, thrombosis). Patients were then...
Rates of preterm delivery in the United States are higher black women compared with whites. In this study, we examined cardiovascular reactivity and risk among white military women.