WUSTL
   

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PI:  George Macones, MD, MSCE
Title:  Pregnancy after LEEP

Purpose:  To assess whether LEEP increases the risk of spontaneous pre-term birth and other adverse pregnancy outcomes, compared to women who have not had a LEEP procedure.

Patient Selection:  Women, 18 to 40 years old in years 1996-2001, who have undergone LEEP, cervical punch biopsy after colposcopy (without LEEP), or Pap smear and are identified from surgical pathology databases. 

P.I.:  George Macones MD, MSCE
Title: Twin Birth Study

Purpose: To determine the best delivery management for twin pregnancies between 32-38 weeks pregnant where Twin A is cephalic, in order to reduce maternal and fetal/neonatal mortality and morbidity.

Patient Selection: Women with twin pregnancies where Twin A is cephalic and they are between 32 and 38 weeks pregnant, each fetus should weigh between 1,500g - 4,000g and who will be willing to willing to have intermittent contact until 2 years following delivery.

P.I. George Macones, MD, MSCE
Title: The Efficacy of Early Amniotomy for Induction of Labor

Purpose:  To investigate the efficacy of artificial rupture of membranes, when the cervix is = 4 cm, on reducing both the duration of labor and the frequency of dystocia in nulliparous women undergoing induction of labor.

Patient Selection:  Patients admitted to Labor & Delivery for scheduled induction of labor who are = 37 weeks gestation.

PI:  George Macones, MD, MSCE
Title:  The Timing of Prophylactic Antibiotics in Cesarean Section and the Risk of Postoperative febrile morbidity; a randomized controlled trial

Purpose:  To determine whether the timing of prophylactic antibiotic administration for C/S (immediate preoperative vs. intraoperative administration) impacts the rate of postoperative febrile morbidity.

Patient Selection:  All patients undergoing non-emergent cesarean section at greater than 36 weeks gestation.

PI:  Anthony Odibo, M.D.
Title:  Optimal timing of the delivery of the preterm growth-restricted pregnancy: A prospective cohort study.

Purpose:  To compare the ability of two antepartum tests, Doppler flow studies of feto-placental vessels and biophysical profile, to optimally determine the timing of delivery of pregnancies with preterm intrauterine growth-restriction (IUGR).

Patient Selection:  Patients with the diagnosis of IUGR will be identified through the Division of Genetics, Maternal-Fetal Medicine and Ultrasound at Washington University School of Medicine.

P.I. Alison Cahill, MD
Title: Pregnancy Outcomes after Prolonged Admission for Fetal Decelerations

Purpose:  To examine the maternal, fetal, and labor outcomes in cases of prolonged admission for electronic fetal monitoring (EFM) after one or more fetal heart rate decelerations.

Patient Selection:  This is a retrospective chart review of all patients admitted to Labor & Delivery for continuous EFM secondary to repetitive fetal heart rate decelerations from January 1, 2004 through April 1, 2006.

PI:  Alison Cahill, MD
Title:  The Prediction of Macrosomia and Birth Trauma in Diabetic Pregnancies

Purpose:  To assess whether fasting blood glucose levels, HgA1c levels, fructosamine levels, or 3-D ultrasound measurements, can accurately predict fetal macrosomia, birth  trauma, or combined neonatal morbidity outcomes.

Patient Selection:  Patients with pre-gestational or gestational diabetes with a confirmed pregnancy will be eligible for this study.

PI:  Alison G. Cahill, M.D.
Title: Imaging for Diagnosing Pulmonary Embolism in Pregnancy

Purpose:  To identify the trends in imaging modality for the diagnosis of pulmonary embolism in the pregnant patient at Barnes-Jewish Hospital. 

Patient Selection:  Pregnant patients who received radiologic imaging to establish the diagnosis of pulmonary embolism, between January 1, 2001 and September 1, 2006, at Barnes Jewish Hospital. 

P.I.: Clayton Skaggs, DC
Title: Musculoskeletal and obstetric management study (MOMS)

Purpose: To determine whether a multi-modal intervention will reduce pain, impairment and disability during and after pregnancy for those patients who have back and pelvic pain in pregnancy.

Patient Selection: Women who are between 24-28 weeks pregnant, aged between 15-45 years and have low back pain or pelvic pain and will be willing to participate in the study until 3 months after delivery.