Shabtai Romano | Technion - Israel Institute of Technology (original) (raw)

Papers by Shabtai Romano

Research paper thumbnail of Intraamniotic infection with Candida albicans successfully treated with transcervical amnioinfusion of amphotericin

American Journal of Obstetrics and Gynecology, May 1, 1994

We present a case in which a pregnant woman was seen at 27 weeks' gestati... more We present a case in which a pregnant woman was seen at 27 weeks' gestation with premature rupture of membranes and intraamniotic infection with Candida albicans, which was treated with transcervical amnioinfusion of amphotericin B. After 7 days of treatment spontaneous vaginal labor developed. A female newborn of 1030 gm was delivered. The infant was normal and did well.

Research paper thumbnail of Association between betamethasone levels and respiratory distress syndrome in preterm births: A prospective cohort study

Clinical and Translational Science

Research paper thumbnail of Impact of “natural” cesarean delivery on peripartum blood loss: a randomized controlled trial

American Journal of Obstetrics & Gynecology MFM

Objective: To examine the impact of “natural” cesarean deliveries (NCD) on peripartum maternal bl... more Objective: To examine the impact of “natural” cesarean deliveries (NCD) on peripartum maternal blood loss. Design: Randomized controlled trial. Setting: Single academic hospital in Afula, Israel, between August 2016 and February 2019. Population or Sample: Term singleton gestations scheduled for a planned CD under spinal anesthesia. Methods: Women were randomized at a ratio of 1:1 to NCD (study group) or traditional CD (control group). Women in the study group watched fetal extraction, had early skin to skin contact, and breastfed until the end of surgery. Neonates in the control group were presented to the mother without direct contact. Blood samples were drawn from all women to determine oxytocin levels using an ELISA kit. Main Outcome Measures: Postpartum hemoglobin (Hb) levels. Results: 214 women randomized, 23 were excluded. There were no significant differences in demographic and obstetric variables between the groups. Postpartum Hb levels were 10.1±1.1 and 10.3±1.3 g/dL in the study and control groups, respectively (P = .19). There were no significant differences in estimated blood loss, and rates of PPH and blood transfusion. Maternal pain scores, satisfaction, and exclusive breastfeeding rate at discharge, were similar. Maternal oxytocin blood levels were 389.5±183.7 and 408.5±233.6 pg/mL in the study and control groups, respectively (P = .96). Rate of composite neonatal morbidity that comprised neonatal hypothermia, hypoglycemia, jaundice, and neonatal intensive care unit admission was higher in the study group. Conclusions: NCD does not affect maternal blood loss. Maternal oxytocin blood levels in NCD and traditional CD are similar.

Research paper thumbnail of Impact of COVID-19 mandatory lockdown on antenatal metabolic health status and pregnancy outcome

American Journal of Obstetrics and Gynecology, 2022

Research paper thumbnail of Effectiveness of antimicrobial prophylaxis at 30 versus 60 min before cesarean delivery

Scientific Reports, 2021

This study aimed to examine the effect of antibiotic prophylaxis (AP) given within 30 compared to... more This study aimed to examine the effect of antibiotic prophylaxis (AP) given within 30 compared to 30–60 min before skin incision on the incidence of infectious morbidity after cesarean delivery (CD). A retrospective cohort study was conducted at a single institution on data between 2014 and 2018. Women who delivered by CD were divided into two groups according to AP timing before skin incision: group 1 within 30 min, and group 2 from 30 to 60 min. The primary outcome was the incidence of any infectious morbidity. Overall, 2989 women were eligible: 2791 in group 1 and 198 in group 2. The primary composite outcome occurred in 125 women (4.48%) in group 1 and 8 women (4.04%) in group 2 (OR, 1.11; 95% CI 0.54–2.31; P = 0.77). The rate of surgical site infection only, was 1.08% in group 1 and 0.51% in group 2 (OR, 2.13; 95% CI 0.29–15.70; P = 0.72). The incidence was comparable between the groups in a separate sub-analysis restricted to laboring CDs and obese women. The rate of infectiou...

Research paper thumbnail of Decreased inferior vena cava diameter as an early marker in postpartum hemorrhage

Ultrasound in Obstetrics & Gynecology, 2021

To examine the association between inferior vena cava (IVC) diameter and postpartum blood loss an... more To examine the association between inferior vena cava (IVC) diameter and postpartum blood loss and assess whether IVC diameter is a useful marker in the evaluation of intravascular volume status in women with postpartum hemorrhage (PPH).

Research paper thumbnail of Trend in cesarean delivery rate among twin pregnancies over a 20 years epoch and the accompanied maternal and perinatal outcomes

European Journal of Obstetrics & Gynecology and Reproductive Biology: X, 2019

To examine the trend of cesarean delivery (CD) rate among twin pregnancies and the trend in mater... more To examine the trend of cesarean delivery (CD) rate among twin pregnancies and the trend in maternal and neonatal morbidities within two decades. Study design: Population-based cohort study, conducted at a single teaching hospital in Israel on data between January 1995 and December 2015. All pregnant women with twin gestation who delivered at a gestational age of 24 weeks or more were included. Data on mode of deliveries, Apgar score <7 at 5 min, cord artery pH < 7.1, early postpartum hemorrhage, blood transfusion, and intrapartum fever for each year were extracted and plotted, and trends were analyzed. CDs performed for one or both twins were divided to laboring, i.e., after a trial of labor, and non-laboring CDs. Data was obtained from the hospital discharge register with ICD-9 codes and crosschecked with the labor medical records. The Cochran-Armitage Trend Test was used to identify trends and correlations. Results: Of all 88,145 deliveries that took place during this period, 1955 (2.2%) were twins. Of these 53 were ineligible and were excluded. There was a statistically significant trend (increase) in twins birth over time (p = 0.004). CD rate increased significantly from 43.4% in 1995 to 66.0% in 2015 (p = 0.001). This increase was observed only among non-laboring cesareans (p = 0.001). Multivariate logistic regression analysis revealed that maternal and early neonatal morbidities examined did not differ significantly during the study period. Conclusion: Non-laboring CD rate increased significantly over the past two decades among twin pregnancies. Despite this increase, maternal and early neonatal morbidities did not change.

Research paper thumbnail of Comparison of single- and double-balloon catheters for labor induction: a systematic review and meta-analysis of randomized controlled trials

Journal of Perinatology, 2017

Objective There is a paucity of head-to-head randomized trials that compare single-and double-bal... more Objective There is a paucity of head-to-head randomized trials that compare single-and double-balloon catheters, and the results of the available data in terms of time from catheter insertion to delivery and delivery mode are mixed. This metaanalysis of randomized controlled trials compares the efficacy of single-and double-balloon catheters in women undergoing labor induction. Study design Searches were made in MEDLINE, EMBASE, PubMed, ClinicalTrials.gov, and the Cochrane Library from inception through June 2016. Peer-reviewed randomized and quasi-randomized trials that compared single-and doubleballoon catheters head-to-head for cervical ripening or labor induction were identified. Eligible study populations consisted of women with singleton pregnancies that had any indication for labor induction and were randomly assigned to undergo induction with a single-or a double-balloon catheter. The primary outcome was time from catheter insertion to delivery and delivery mode. The secondary outcomes were intrapartum fever or chorioamnionitis, woman's satisfaction, and neonatal Apgar score. Results Of the 520 records identified, five randomized trials (996 women; 491 with single-balloon and 505 with doubleballoon catheters) were considered eligible and included in the meta-analysis. Time from catheter insertion to delivery did not differ between the two types of catheter (p = 0.527; WMD −0.87; 95% CI: −3.55, 1.82). The incidence of cesarean delivery also did not differ (p = 0.844; RR 0.97; 95% CI: 0.69, 1.35). Delivery within 24 h, delivery mode, incidences of intrapartum fever or chorioamnionitis, and neonatal Apgar score <7 at 5 min did not differ between the two types of catheter as well. Women who were induced with the single-balloon catheter were more satisfied (p = 0.029; WMD 0.56; 95% CI: 0.06, 1.06). Conclusion Time from catheter insertion to delivery and delivery mode were comparable between the two types of catheter.

Research paper thumbnail of 17 (1989) 393 Prenatal diagnosis using sonographic guided cordocentesis

Research paper thumbnail of The safety of quinolones and fluoroquinolones in pregnancy: a meta-analysis

BJOG: An International Journal of Obstetrics & Gynaecology, 2018

Background Quinolones were contraindicated during pregnancy because of concerns regarding fetal m... more Background Quinolones were contraindicated during pregnancy because of concerns regarding fetal malformations and carcinogenesis in animals. The literature is conflicting regarding their safety in humans. Objectives To conduct a meta-analysis evaluating the risk for fetal malformations and pregnancy complications following exposure to quinolones during pregnancy. Search strategy We searched Embase, PubMed, Medline, the Cochrane database, clinicaltrials.gov, and Dart Databases. We added articles found through the references of included articles. Selection criteria Relevant English citations using the terms quinolone/s, fluoroquinolone/s, and pregnancy in humans. Exclusion criteria were case reports, reviews, and articles without data regarding the study outcomes. Data collection and analysis Two authors performed the database search, assessment of eligibility, and abstraction of data from included studies. Disagreement was settled by consensus among all authors. The pooled odds ratios (with 95% CIs) were estimated. The Cochrane's Q-test of heterogeneity and I² were used for the measurement of heterogeneity. A total of 256 papers were retrieved, 13 of which met the inclusion criteria and were then analysed. Main results No association was found between quinolones and fetal malformations (pooled odds ratio, OR 1.08; 95% CI 0.96-1.21), preterm delivery (pooled OR 0.97; 95% CI 0.75-1.24), stillbirth (pooled OR 1.11; 95% CI 0.34-3.6), or miscarriage (pooled OR 1.78; 95% CI 0.93-3.38). Conclusions Quinolones are not associated with unfavourable pregnancy outcomes; however, larger studies are needed before safety is established. Until then, it is suggested that quinolones should not be used as a first-line therapy during the first trimester.

Research paper thumbnail of 879: Antimicrobial prophylaxis within 30 versus 30-60 minutes before cesarean delivery and surgical site infection rate

American Journal of Obstetrics and Gynecology, 2020

Research paper thumbnail of 549: Placenta accreta and Intra-abdominal adhesions; the bright side

American Journal of Obstetrics and Gynecology, 2018

Research paper thumbnail of A Randomized Trial of Incisional Infiltration With Bupivacain/Adrenalin During Cesarean Section in Reducing Postoperative Pain

American Journal of Obstetrics and Gynecology, 2022

Research paper thumbnail of The association between ABO blood groups and gestational diabetes mellitus: a retrospective population-based cohort study

OBJECTIVE There is a lot of evidence that connects blood type to several diseases, including the ... more OBJECTIVE There is a lot of evidence that connects blood type to several diseases, including the development of diabetes mellitus type 2. The evidence for an association between ABO blood groups and the possibility of developing gestational diabetes mellitus (GDM) is scant and inconclusive. We aimed to examine the link between ABO blood group types and GDM by the use of a large population-based cohort of pregnant women. STUDY DESIGN A retrospective population-based cohort study was conducted using data collected from January 2013 to December 2017 from the Emek Medical Center, Afula, Israel. All pregnant women who underwent the two-step screening and diagnosed with GDM and delivered at >24 weeks were included. Women who had pre-gestational diabetes or whose pregnancies were terminated were excluded. The odds ratio (OR) were obtained through binary logistic regression analysis and the corresponding 95% confidence interval (CI) by the use of both the univariable and multivariable an...

Research paper thumbnail of Implementing military aviation debriefing methods to improve outcome of peripartum interventional procedures

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2019

Research paper thumbnail of 915: Can respiratory distress syndrome be predicted according to serum betamethasone levels in preterm births?

American Journal of Obstetrics and Gynecology, 2020

The currently recommended betamethasone (BM) dosage was determined in the 1970s; regardless of ge... more The currently recommended betamethasone (BM) dosage was determined in the 1970s; regardless of gestational age (GA), maternal weight, and number of fetuses. We aimed to determine maternal serum levels (MSL) before birth and neonatal serum levels (NSL) to predict neonatal respiratory distress syndrome (RDS). STUDY DESIGN: Prospective study conducted at a single institution between August 2016 and February 2019. Women delivered between 28-34 weeks were included. BM was given in 2 doses; 12 mg each, 24h apart. MSL, prior to delivery, and NSL (cord artery) were analyzed using Corticosteroid ELISA kit, (Randox Laboratories Ltd., UK) that was previously validated (Salim R, et al. RB&E, 2016). The reported RDS rate between 28 and 34 weeks is 20%. We assumed that NSL will accurately detect RDS in 95%. Hence, 150 neonates were needed (power 80%, alpha 0.05). RESULTS: Overall 124 women were included; 96 (77.4%) singletons, 26 twins (21.0%) and 2 triplets (1.6%), corresponding to 154 neonates. RDS was diagnosed in 35 (22.7%) neonates. Neither MSL nor NSL differ significantly between neonates with and without RDS. Number of fetuses, maternal weight, indication for BM, and delivery mode were not significant predictors of MSL. Cox regression analysis revealed that after correcting for these confounders, GA and diabetes, MSL was a significant predictor (p¼0.008) for RDS; for every 1 ng/mL increase in MSL a 3% increase in odds of RDS was noted. The AUC was 0.746 (95% CI: 0.582-0.911; p¼0.03). After deleting women delivered < 24 hours and > week from the last dose, a threshold of 4.42 ng/mL had sensitivity of 0.875 and specificity of 0.547. NSL was a significant predictor (p¼0.001) of RDS after performing the same analysis. The odds of RDS increased by 1.29 for every 1 ng/mL increase in neonatal serum level (OR: 1.29; 95% CI: 1.12-1.48). The AUC was 0.645 (95% CI: 0.495-0.795; p¼0.09). CONCLUSION: NSL and MSL predicted RDS. Compared to MSL, NSL was poor at separating RDS neonates. Additionally, RDS rate increased with increased BM levels. The current recommended BM dosage probably needs modifications.

Research paper thumbnail of 495: Risk factors and trend in severe maternal morbidities over a decade

American Journal of Obstetrics and Gynecology, 2020

Research paper thumbnail of 1122: Pethidine versus nitrous oxide for pain relief during labor among multiparous. A randomized controlled trial

American Journal of Obstetrics and Gynecology, 2020

Research paper thumbnail of Double‐blind randomized trial of progesterone to prevent preterm birth in second trimester bleeding

Acta Obstetricia et Gynecologica Scandinavica, 2019

Second‐trimester vaginal bleeding increases the risk of spontaneous preterm birth. We aimed to ex... more Second‐trimester vaginal bleeding increases the risk of spontaneous preterm birth. We aimed to examine the efficacy of vaginal progesterone to reduce preterm birth rate in women with second‐trimester vaginal bleeding.

Research paper thumbnail of 978: The impact of "Natural” cesarean delivery on peripartum maternal blood loss. A randomized controlled trial

American Journal of Obstetrics and Gynecology, 2019

Research paper thumbnail of Intraamniotic infection with Candida albicans successfully treated with transcervical amnioinfusion of amphotericin

American Journal of Obstetrics and Gynecology, May 1, 1994

We present a case in which a pregnant woman was seen at 27 weeks&amp;amp;amp;amp;#39; gestati... more We present a case in which a pregnant woman was seen at 27 weeks&amp;amp;amp;amp;#39; gestation with premature rupture of membranes and intraamniotic infection with Candida albicans, which was treated with transcervical amnioinfusion of amphotericin B. After 7 days of treatment spontaneous vaginal labor developed. A female newborn of 1030 gm was delivered. The infant was normal and did well.

Research paper thumbnail of Association between betamethasone levels and respiratory distress syndrome in preterm births: A prospective cohort study

Clinical and Translational Science

Research paper thumbnail of Impact of “natural” cesarean delivery on peripartum blood loss: a randomized controlled trial

American Journal of Obstetrics & Gynecology MFM

Objective: To examine the impact of “natural” cesarean deliveries (NCD) on peripartum maternal bl... more Objective: To examine the impact of “natural” cesarean deliveries (NCD) on peripartum maternal blood loss. Design: Randomized controlled trial. Setting: Single academic hospital in Afula, Israel, between August 2016 and February 2019. Population or Sample: Term singleton gestations scheduled for a planned CD under spinal anesthesia. Methods: Women were randomized at a ratio of 1:1 to NCD (study group) or traditional CD (control group). Women in the study group watched fetal extraction, had early skin to skin contact, and breastfed until the end of surgery. Neonates in the control group were presented to the mother without direct contact. Blood samples were drawn from all women to determine oxytocin levels using an ELISA kit. Main Outcome Measures: Postpartum hemoglobin (Hb) levels. Results: 214 women randomized, 23 were excluded. There were no significant differences in demographic and obstetric variables between the groups. Postpartum Hb levels were 10.1±1.1 and 10.3±1.3 g/dL in the study and control groups, respectively (P = .19). There were no significant differences in estimated blood loss, and rates of PPH and blood transfusion. Maternal pain scores, satisfaction, and exclusive breastfeeding rate at discharge, were similar. Maternal oxytocin blood levels were 389.5±183.7 and 408.5±233.6 pg/mL in the study and control groups, respectively (P = .96). Rate of composite neonatal morbidity that comprised neonatal hypothermia, hypoglycemia, jaundice, and neonatal intensive care unit admission was higher in the study group. Conclusions: NCD does not affect maternal blood loss. Maternal oxytocin blood levels in NCD and traditional CD are similar.

Research paper thumbnail of Impact of COVID-19 mandatory lockdown on antenatal metabolic health status and pregnancy outcome

American Journal of Obstetrics and Gynecology, 2022

Research paper thumbnail of Effectiveness of antimicrobial prophylaxis at 30 versus 60 min before cesarean delivery

Scientific Reports, 2021

This study aimed to examine the effect of antibiotic prophylaxis (AP) given within 30 compared to... more This study aimed to examine the effect of antibiotic prophylaxis (AP) given within 30 compared to 30–60 min before skin incision on the incidence of infectious morbidity after cesarean delivery (CD). A retrospective cohort study was conducted at a single institution on data between 2014 and 2018. Women who delivered by CD were divided into two groups according to AP timing before skin incision: group 1 within 30 min, and group 2 from 30 to 60 min. The primary outcome was the incidence of any infectious morbidity. Overall, 2989 women were eligible: 2791 in group 1 and 198 in group 2. The primary composite outcome occurred in 125 women (4.48%) in group 1 and 8 women (4.04%) in group 2 (OR, 1.11; 95% CI 0.54–2.31; P = 0.77). The rate of surgical site infection only, was 1.08% in group 1 and 0.51% in group 2 (OR, 2.13; 95% CI 0.29–15.70; P = 0.72). The incidence was comparable between the groups in a separate sub-analysis restricted to laboring CDs and obese women. The rate of infectiou...

Research paper thumbnail of Decreased inferior vena cava diameter as an early marker in postpartum hemorrhage

Ultrasound in Obstetrics & Gynecology, 2021

To examine the association between inferior vena cava (IVC) diameter and postpartum blood loss an... more To examine the association between inferior vena cava (IVC) diameter and postpartum blood loss and assess whether IVC diameter is a useful marker in the evaluation of intravascular volume status in women with postpartum hemorrhage (PPH).

Research paper thumbnail of Trend in cesarean delivery rate among twin pregnancies over a 20 years epoch and the accompanied maternal and perinatal outcomes

European Journal of Obstetrics & Gynecology and Reproductive Biology: X, 2019

To examine the trend of cesarean delivery (CD) rate among twin pregnancies and the trend in mater... more To examine the trend of cesarean delivery (CD) rate among twin pregnancies and the trend in maternal and neonatal morbidities within two decades. Study design: Population-based cohort study, conducted at a single teaching hospital in Israel on data between January 1995 and December 2015. All pregnant women with twin gestation who delivered at a gestational age of 24 weeks or more were included. Data on mode of deliveries, Apgar score <7 at 5 min, cord artery pH < 7.1, early postpartum hemorrhage, blood transfusion, and intrapartum fever for each year were extracted and plotted, and trends were analyzed. CDs performed for one or both twins were divided to laboring, i.e., after a trial of labor, and non-laboring CDs. Data was obtained from the hospital discharge register with ICD-9 codes and crosschecked with the labor medical records. The Cochran-Armitage Trend Test was used to identify trends and correlations. Results: Of all 88,145 deliveries that took place during this period, 1955 (2.2%) were twins. Of these 53 were ineligible and were excluded. There was a statistically significant trend (increase) in twins birth over time (p = 0.004). CD rate increased significantly from 43.4% in 1995 to 66.0% in 2015 (p = 0.001). This increase was observed only among non-laboring cesareans (p = 0.001). Multivariate logistic regression analysis revealed that maternal and early neonatal morbidities examined did not differ significantly during the study period. Conclusion: Non-laboring CD rate increased significantly over the past two decades among twin pregnancies. Despite this increase, maternal and early neonatal morbidities did not change.

Research paper thumbnail of Comparison of single- and double-balloon catheters for labor induction: a systematic review and meta-analysis of randomized controlled trials

Journal of Perinatology, 2017

Objective There is a paucity of head-to-head randomized trials that compare single-and double-bal... more Objective There is a paucity of head-to-head randomized trials that compare single-and double-balloon catheters, and the results of the available data in terms of time from catheter insertion to delivery and delivery mode are mixed. This metaanalysis of randomized controlled trials compares the efficacy of single-and double-balloon catheters in women undergoing labor induction. Study design Searches were made in MEDLINE, EMBASE, PubMed, ClinicalTrials.gov, and the Cochrane Library from inception through June 2016. Peer-reviewed randomized and quasi-randomized trials that compared single-and doubleballoon catheters head-to-head for cervical ripening or labor induction were identified. Eligible study populations consisted of women with singleton pregnancies that had any indication for labor induction and were randomly assigned to undergo induction with a single-or a double-balloon catheter. The primary outcome was time from catheter insertion to delivery and delivery mode. The secondary outcomes were intrapartum fever or chorioamnionitis, woman's satisfaction, and neonatal Apgar score. Results Of the 520 records identified, five randomized trials (996 women; 491 with single-balloon and 505 with doubleballoon catheters) were considered eligible and included in the meta-analysis. Time from catheter insertion to delivery did not differ between the two types of catheter (p = 0.527; WMD −0.87; 95% CI: −3.55, 1.82). The incidence of cesarean delivery also did not differ (p = 0.844; RR 0.97; 95% CI: 0.69, 1.35). Delivery within 24 h, delivery mode, incidences of intrapartum fever or chorioamnionitis, and neonatal Apgar score <7 at 5 min did not differ between the two types of catheter as well. Women who were induced with the single-balloon catheter were more satisfied (p = 0.029; WMD 0.56; 95% CI: 0.06, 1.06). Conclusion Time from catheter insertion to delivery and delivery mode were comparable between the two types of catheter.

Research paper thumbnail of 17 (1989) 393 Prenatal diagnosis using sonographic guided cordocentesis

Research paper thumbnail of The safety of quinolones and fluoroquinolones in pregnancy: a meta-analysis

BJOG: An International Journal of Obstetrics & Gynaecology, 2018

Background Quinolones were contraindicated during pregnancy because of concerns regarding fetal m... more Background Quinolones were contraindicated during pregnancy because of concerns regarding fetal malformations and carcinogenesis in animals. The literature is conflicting regarding their safety in humans. Objectives To conduct a meta-analysis evaluating the risk for fetal malformations and pregnancy complications following exposure to quinolones during pregnancy. Search strategy We searched Embase, PubMed, Medline, the Cochrane database, clinicaltrials.gov, and Dart Databases. We added articles found through the references of included articles. Selection criteria Relevant English citations using the terms quinolone/s, fluoroquinolone/s, and pregnancy in humans. Exclusion criteria were case reports, reviews, and articles without data regarding the study outcomes. Data collection and analysis Two authors performed the database search, assessment of eligibility, and abstraction of data from included studies. Disagreement was settled by consensus among all authors. The pooled odds ratios (with 95% CIs) were estimated. The Cochrane's Q-test of heterogeneity and I² were used for the measurement of heterogeneity. A total of 256 papers were retrieved, 13 of which met the inclusion criteria and were then analysed. Main results No association was found between quinolones and fetal malformations (pooled odds ratio, OR 1.08; 95% CI 0.96-1.21), preterm delivery (pooled OR 0.97; 95% CI 0.75-1.24), stillbirth (pooled OR 1.11; 95% CI 0.34-3.6), or miscarriage (pooled OR 1.78; 95% CI 0.93-3.38). Conclusions Quinolones are not associated with unfavourable pregnancy outcomes; however, larger studies are needed before safety is established. Until then, it is suggested that quinolones should not be used as a first-line therapy during the first trimester.

Research paper thumbnail of 879: Antimicrobial prophylaxis within 30 versus 30-60 minutes before cesarean delivery and surgical site infection rate

American Journal of Obstetrics and Gynecology, 2020

Research paper thumbnail of 549: Placenta accreta and Intra-abdominal adhesions; the bright side

American Journal of Obstetrics and Gynecology, 2018

Research paper thumbnail of A Randomized Trial of Incisional Infiltration With Bupivacain/Adrenalin During Cesarean Section in Reducing Postoperative Pain

American Journal of Obstetrics and Gynecology, 2022

Research paper thumbnail of The association between ABO blood groups and gestational diabetes mellitus: a retrospective population-based cohort study

OBJECTIVE There is a lot of evidence that connects blood type to several diseases, including the ... more OBJECTIVE There is a lot of evidence that connects blood type to several diseases, including the development of diabetes mellitus type 2. The evidence for an association between ABO blood groups and the possibility of developing gestational diabetes mellitus (GDM) is scant and inconclusive. We aimed to examine the link between ABO blood group types and GDM by the use of a large population-based cohort of pregnant women. STUDY DESIGN A retrospective population-based cohort study was conducted using data collected from January 2013 to December 2017 from the Emek Medical Center, Afula, Israel. All pregnant women who underwent the two-step screening and diagnosed with GDM and delivered at >24 weeks were included. Women who had pre-gestational diabetes or whose pregnancies were terminated were excluded. The odds ratio (OR) were obtained through binary logistic regression analysis and the corresponding 95% confidence interval (CI) by the use of both the univariable and multivariable an...

Research paper thumbnail of Implementing military aviation debriefing methods to improve outcome of peripartum interventional procedures

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2019

Research paper thumbnail of 915: Can respiratory distress syndrome be predicted according to serum betamethasone levels in preterm births?

American Journal of Obstetrics and Gynecology, 2020

The currently recommended betamethasone (BM) dosage was determined in the 1970s; regardless of ge... more The currently recommended betamethasone (BM) dosage was determined in the 1970s; regardless of gestational age (GA), maternal weight, and number of fetuses. We aimed to determine maternal serum levels (MSL) before birth and neonatal serum levels (NSL) to predict neonatal respiratory distress syndrome (RDS). STUDY DESIGN: Prospective study conducted at a single institution between August 2016 and February 2019. Women delivered between 28-34 weeks were included. BM was given in 2 doses; 12 mg each, 24h apart. MSL, prior to delivery, and NSL (cord artery) were analyzed using Corticosteroid ELISA kit, (Randox Laboratories Ltd., UK) that was previously validated (Salim R, et al. RB&E, 2016). The reported RDS rate between 28 and 34 weeks is 20%. We assumed that NSL will accurately detect RDS in 95%. Hence, 150 neonates were needed (power 80%, alpha 0.05). RESULTS: Overall 124 women were included; 96 (77.4%) singletons, 26 twins (21.0%) and 2 triplets (1.6%), corresponding to 154 neonates. RDS was diagnosed in 35 (22.7%) neonates. Neither MSL nor NSL differ significantly between neonates with and without RDS. Number of fetuses, maternal weight, indication for BM, and delivery mode were not significant predictors of MSL. Cox regression analysis revealed that after correcting for these confounders, GA and diabetes, MSL was a significant predictor (p¼0.008) for RDS; for every 1 ng/mL increase in MSL a 3% increase in odds of RDS was noted. The AUC was 0.746 (95% CI: 0.582-0.911; p¼0.03). After deleting women delivered < 24 hours and > week from the last dose, a threshold of 4.42 ng/mL had sensitivity of 0.875 and specificity of 0.547. NSL was a significant predictor (p¼0.001) of RDS after performing the same analysis. The odds of RDS increased by 1.29 for every 1 ng/mL increase in neonatal serum level (OR: 1.29; 95% CI: 1.12-1.48). The AUC was 0.645 (95% CI: 0.495-0.795; p¼0.09). CONCLUSION: NSL and MSL predicted RDS. Compared to MSL, NSL was poor at separating RDS neonates. Additionally, RDS rate increased with increased BM levels. The current recommended BM dosage probably needs modifications.

Research paper thumbnail of 495: Risk factors and trend in severe maternal morbidities over a decade

American Journal of Obstetrics and Gynecology, 2020

Research paper thumbnail of 1122: Pethidine versus nitrous oxide for pain relief during labor among multiparous. A randomized controlled trial

American Journal of Obstetrics and Gynecology, 2020

Research paper thumbnail of Double‐blind randomized trial of progesterone to prevent preterm birth in second trimester bleeding

Acta Obstetricia et Gynecologica Scandinavica, 2019

Second‐trimester vaginal bleeding increases the risk of spontaneous preterm birth. We aimed to ex... more Second‐trimester vaginal bleeding increases the risk of spontaneous preterm birth. We aimed to examine the efficacy of vaginal progesterone to reduce preterm birth rate in women with second‐trimester vaginal bleeding.

Research paper thumbnail of 978: The impact of "Natural” cesarean delivery on peripartum maternal blood loss. A randomized controlled trial

American Journal of Obstetrics and Gynecology, 2019