Justin R Lappen

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OBJECTIVE Multiple scoring systems exist to identify inpatients who are at risk for clinical deterioration. None of these systems have been evaluated in an obstetric population. We examined the Systemic Inflammatory Response syndrome (SIRS) and Modified Early Warning score (MEWS) criteria in pregnant women with chorioamnionitis. STUDY DESIGN This was an(More)
OBJECTIVE To determine whether sleep-disordered breathing (SDB) is more prevalent among women with preeclampsia than among normotensive controls. STUDY DESIGN Preeclamptic patients admitted to the hospital for observation and normotensive, gestational age matched controls hospitalized for obstetrical indications other than preeclampsia were recruited for(More)
OBJECTIVE We sought to compare the predictive power of published modified obstetric early warning scoring systems (MOEWS) for the development of severe sepsis in women with chorioamnionitis. STUDY DESIGN This was a retrospective cohort study using prospectively collected clinical observations at a single tertiary unit (Chicago, IL). Hospital databases and(More)
Case reviews of maternal death have revealed a concerning pattern of delay in recognition of hemorrhage, hypertensive crisis, sepsis, venous thromboembolism, and heart failure. Early-warning systems have been proposed to facilitate timely recognition, diagnosis, and treatment for women developing critical illness. A multidisciplinary working group convened(More)
BACKGROUND By increasing intraabdominal pressure, pregnancy may increase the risk of abdominal hernia recurrence. Current data are limited to studies with small sample size and thus the impact of pregnancy on recurrence is unclear. OBJECTIVE(S) The objective of this analysis was to evaluate the impact of pregnancy on clinically significant abdominal(More)
BACKGROUND Anecdotal evidence has suggested an association of intravenous drug abuse with alloimmunization; however, published data are limited to case reports. OBJECTIVE The purpose of this study was to determine whether women with a history of intravenous drug abuse have an increased risk of alloimmunization. STUDY DESIGN A retrospective cohort study(More)
Introduction. Dyspnea during pregnancy and in the immediate postpartum or postoperative period is a relatively common symptom that can be an early sign of a life threatening condition. The differential diagnosis is broad and can represent a wide variety of underlying etiologies. Cardiac tumors are one of the rarest causes of dyspnea in a reproductive age(More)
The rise in maternal morbidity and mortality has resulted in national and international attention at optimally organizing systems and teams for pregnancy care. Given that maternal morbidity and mortality can occur unpredictably in any obstetric setting, specialists in general obstetrics and gynecology along with other primary maternal care providers should(More)
OBJECTIVE To determine whether the introduction of a postpartum hemorrhage (PPH) patient safety program was associated with changes in patient care or outcomes. STUDY DESIGN A multipronged patient safety program regarding PPH was instituted at a tertiary care maternity hospital. Patient care and outcomes were assessed for 6 months prior to (period A) and(More)