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To assess the association between women with preterm premature rupture of membranes and 41 potential risk factors, we conducted a case-control study in six United States tertiary perinatal centers. The study involved completion of a comprehensive questionnaire for 341 women with preterm premature rupture of membranes in singleton pregnancies from 20 to 36(More)
Isolation of Candida albicans from the vaginal secretions of pregnant women occurs with an incidence of 5-23%. Intrauterine infection caused by Candida during pregnancy is relatively rare; only 81 cases, all diagnosed after delivery, have been reported. We report six cases of candidal chorioamnionitis diagnosed by amniocentesis and confirmed by histologic(More)
Perinatal units differ in their ability to prevent patient injury and medical malpractice litigation. Obstetrical units with favorable performance are distinguished by common organizational and clinical features. Organizationally, they resemble what behavioral scientists define as "high-reliability organizations" (i.e., the ability to operate(More)
OBJECTIVE To describe communication between nurses and physicians during labor within the context of the nurse-managed labor model in community hospitals and its relationship to teamwork and patient safety. DESIGN Multicenter qualitative study involving focus groups and in-depth interviews. SETTING Labor and birth units in 4 Midwestern community(More)
Magnesium sulfate is commonly used in obstetrical practice both as seizure prophylaxis in women with preeclampsia, as well as to inhibit preterm labor contractions. However, despite (and perhaps because of) years of use and provider familiarity, the administration of magnesium sulfate occasionally results in accidental overdose and patient harm.(More)
BACKGROUND Preventable harm to mothers and infants during labor and birth is a significant patient safety and professional liability issue. A Michigan Health & Hospital Association Keystone Center for Patient Safety & Quality Obstetric Collaborative Project involved perinatal teams from 15 Michigan hospitals during an 11-month period in 2009. The purpose of(More)
Oxytocin is the drug most commonly associated with preventable adverse perinatal outcomes and was recently added by the Institute for Safe Medication Practices to a small list of medications "bearing a heightened risk of harm," which may "require special safeguards to reduce the risk of error." Current recommendations for the administration of this drug are(More)
Reducing the risk of liability exposure and avoiding preventable injuries to mothers and infants during labor and birth can be relatively easy when all members of the perinatal care team (nurses, nurse-midwives, and physicians) agree to follow two basic tenets of clinical practice: use applicable evidence and/or published standards and guidelines as the(More)
C-reactive protein (CRP) was determined serially in 31 patients with premature rupture of the membranes, 41 patients in premature labor, and 18 pregnant patients with a variety of high-risk conditions. Elevated levels of CRP were not predictive of clinical amnionitis, histologic chorioamnionitis, or neonatal sepsis. No discernible relationship was found(More)
Previous studies have demonstrated a high correlation between elevated resistance in the placental circulation, evidenced by abnormal umbilical artery systolic-to-diastolic (S/D) ratios, and the subsequent birth of a small for gestational age (SGA) infant. However, few data exist on the significance of elevated S/D ratios for pregnancies in which outcome(More)