In patients with an ultrasound or physical exam indicated cerclage, a positive fFN and a short cervical length are both associated with preterm birth. The risk of preterm birth increase with the number of abnormal biomarkers.
Cervical Pessary and Vaginal Progesterone in Twin Pregnancies with a Short Cervix
For twin pregnancies with a short cervix, the addition of a cervical pessary to vaginal progesterone is associated with prolonged pregnancy and reduced risk of adverse neonatal outcomes. A large randomized trial should be performed to verify these retrospective findings.
Natural History of Vasa Previa Across Gestation Using a Screening Protocol
Vasa previa is a rare condition of pregnancy where a fetal blood vessel crosses over the maternal cervix. If unrecognized, it is extremely dangerous as the blood vessel can rupture during labor when the cervix dilates. Historically, there was less than a 50% newborn survival rate with this condition. However, when diagnosed before delivery, a
Active Second-Stage Management in Twin Pregnancies Undergoing Planned Vaginal Delivery in a U.S. Population
For women with twin pregnancies, safe delivery of the babies is critically important. Recently, many providers have begun recommending cesarean delivery for all or most women with twins. At MFMA, we believe vaginal delivery of twins is a safe and reasonable option for many women with twin pregnancies. In this 2010 publication in Obstetrics and
Successful Bilateral Uterine Artery Embolization During an Ongoing Pregnancy
At Carnegie Imaging, we use the latest and most up to date technology in diagnosing and treating complicated conditions of pregnancy. In this 2009 publication in Obstetrics and Gynecology, we describe a case of a large arteriovenous malformation (AVM) complicating pregnancy. After her obstetrician recommended she terminate the pregnancy and undergo hysterectomy, she came to
Weight Gain in Twin Pregnancies and Adverse Outcomes
Twin pregnancies are at increased risk of fetal growth restriction, which is when babies are born smaller than expected, usually due to poor transport of nutrients from the mother to the baby (or babies) across the placenta. There are few known interventions to reduce the risk of growth restriction in twin pregnancies, but in this
Gestational Age at Cervical Length and Fetal Fibronectin Assessment and the Incidence of Spontaneous Preterm Birth in Twins
At MFMA and Carnegie Imaging, we utilize cervical length and fetal fibronectin (fFN) screening in patients at increased risk for preterm birth, such as twin pregnancies. This 2015 publication in the Journal of Ultrasound in Medicine is the basis for our twin preterm birth calculator (www.mfmnyc.com/twin) and allows patients and doctors to predict the risk
First-Trimester Anueploidy Risk Assessment: The Impact of Comprehensive Counseling and Same-Day Results on Patient Satisfaction, Anxiety, and Knowledge
At Carnegie Imaging, women undergoing aneuploidy risk assessment (screening for Down Syndrome and other genetic conditions) have the option of Instant Risk Assessment (IRA), which allows women to receive their final results and counseling by one of our Maternal Fetal Medicine specialists on the day of their 11-13 week nuchal translucency ultrasound at Carnegie Imaging.
Ultrasound-indicated cerclage: Shirodkar vs. McDonald
Cervical cerclage is a procedure performed to reduce the risk of preterm birth in certain high-risk pregnancies. There are two techniques for this procedure, the McDonald cerclage and the Shirodkar cerclage. Traditionally, it was unknown which procedure type was superior. In this 2012 publication we showed that the Shirodkar type, which is the preferred method
Outcomes of emergency or physical examination-indicated cerclage in twin pregnancies compared to singleton pregnancies
Cervical cerclage is a procedure performed to reduce the risk of preterm birth in certain high-risk pregnancies. Despite its wide spread use, there is much controversy over which circumstances cerclage is actually beneficial. One such difficult clinical scenario is a patient with a dilated cervix in the second trimester. In this 2014 publication in the