Robert M. Silver

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OBJECTIVE Although repeat cesarean deliveries often are associated with serious morbidity, they account for only a portion of abdominal deliveries and are overlooked when evaluating morbidity. Our objective was to estimate the magnitude of increased maternal morbidity associated with increasing number of cesarean deliveries. METHODS Prospective(More)
OBJECTIVE To determine which interventions for managing placenta accreta were associated with reduced maternal morbidity. DESIGN Retrospective cohort study. SETTING Two tertiary care teaching hospitals in Utah. POPULATION All identified cases of placenta accreta from 1996 to 2008. METHODS Cases of placenta accreta were identified using standard(More)
Copyright © 2010 Massachusetts Medical Society. A 32-year-old woman presents for evaluation after three consecutive miscarriages. Before these miscarriages, she had one successful pregnancy. The patient reports no medical problems or previous surgeries. In her first miscarriage, uterine bleeding and cramping started in the 7th week of gestation, and an(More)
OBJECTIVE Some investigators have found a high frequency of abortus aneuploidy in women with recurrent miscarriage, suggesting the possibility of recurrent aneuploidy as a cause of recurrent miscarriage. Others contend that aneuploidy is not a cause of recurrent miscarriage. The purpose of this study was to investigate the relationship between fetal(More)
Since Medawar's initial contemplations in 1953 on the mechanisms of immune evasion allowing for the survival of the allogeneic conceptus in an immunologically competent mother, physicians and immunologists alike have struggled to understand the immunological paradox of pregnancy. Ultimately, our attempts to define the immunology of normal pregnancy have(More)
Despite improvements in antenatal and intrapartum care, stillbirth, defined as in utero fetal death at 20 weeks of gestation or greater, remains an important, largely unstudied, and poignant problem in obstetrics. More than 26,000 stillbirths were reported in the United States in 2001. Although several conditions have been linked to stillbirth, it is(More)
OBJECTIVE To compare placental lesions for stillbirth cases and live birth controls in a population-based study. METHODS Pathologic examinations were performed on placentas from singleton pregnancies using a standard protocol. Data were analyzed overall and within gestational age groups at delivery. RESULTS Placentas from 518 stillbirths and 1,200 live(More)
OBJECTIVE To provide healthcare providers, patients, and the general public with a responsible assessment of currently available data on diagnosing gestational diabetes mellitus (GDM). PARTICIPANTS A non-U.S. Department of Health and Human Services, nonadvocate 15-member panel representing the fields of obstetrics and gynecology, maternal-fetal medicine,(More)
Over the last century, the incidence of placenta accreta, increta, and percreta, collectively referred to as morbidly adherent placenta, has risen dramatically. Planned cesarean hysterectomy at the time of cesarean delivery is the standard recommended treatment in the United States. Recently, interest in conservative management has resurged, especially in(More)
OBJECTIVE Treatment with heparin and low-dose aspirin improves fetal survival among women with antiphospholipid syndrome. Despite treatment, however, these pregnancies are frequently complicated by preeclampsia, fetal growth restriction, and placental insufficiency, often with the result of preterm birth. Small case series suggest that intravenous immune(More)