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DECEMBER 2014 - Volume 211, Number 6 ON THE COVER

E DITORIALS
575 The CROWN Initiative: journal editors invite researchers to develop
core outcomes in women’s health
Khalid S. Khan; Roberto Romero; on behalf of Chief Editors of Journals
participating in The CROWN Initiative

577 Noninvasive prenatal testing: need for informed enthusiasm

Christina S. Han; Lawrence D. Platt Aminopeptidase-Q (laeverin), a
See related article, page 651 new potential biomarker of pre-
eclampsia, is expressed in the plasma
581 State-based maternal death reviews: assessing opportunities to membrane of villous trophoblasts
alter outcomes (green) in normal placenta.
William M. Callaghan Related article, page 686
See related article, page 698
Image by Mona Nystad, MSc, University

E XPERT R EVIEWS
Hospital of North Norway, Tromsø, Norway.

OBSTETRICS

583 Prediction of preterm birth in twin gestations using biophysical and

biochemical tests
Agustin Conde-Agudelo; Roberto Romero
This article reviews the value of biophysical and biochemical tests proposed for the
prediction of preterm birth in both asymptomatic and symptomatic women with
twin gestations.

C LINICAL O PINION
EDUCATION

596 Peer review of medical practices: missed opportunities to learn

Nicholas Kadar
Appropriately conducted peer review of medical practices provides the greatest
opportunity for health care professionals to learn from their mistakes and improve The American Journal of Obstetrics & Gynecol-
ogy (ISSN 0002-9378) is published monthly by
the quality and safety of health care, it must be standardized to remove cognitive Elsevier Inc., 360 Park Avenue South, New York,
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DECEMBER 2014 American Journal of Obstetrics & Gynecology 1A

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C LINICAL O PINION (continued)

OBSTETRICS

602 Treating morning sickness in the United States—changes in

prescribing are needed
Gideon Koren
Changes in prescription for morning sickness are needed.

SMFM S PECIAL R EPORT

607 Society for Maternal-Fetal Medicine (SMFM) Special Report: the
maternal-fetal medicine subspecialists’ role within a health care system
Society for Maternal-Fetal Medicine (SMFM); Anthony Sciscione;
Vincenzo Berghella; Sean Blackwell; Kim Boggess; Andrew Helfgott;
Brian Iriye; James Keller; M. Kathryn Menard; Daniel O’Keeffe;
Laura Riley; Joanne Stone
The MFM subspecialist’s roles within heath care systems are reviewed,
including consultation, co-management, and transfer of care, as well as
education, research, and leadership.

C ALL TO A CTION
617 The future of obstetrics/gynecology in 2020: a clearer vision: finding true
north and the forces of change
David C. Lagrew Jr; Todd R. Jenkins
The ‘Triple Aim’ concept of health care reform can be used as a guidepost for the
evaluation of potential changes to health care delivery. Within this construct, we
introduce the ‘transformational forces’ of payment reform and care redesign.

R ESEARCH
GYNECOLOGY

623 Outcomes from ultrasound follow-up of small complex adnexal masses

in women over 50
Elizabeth Suh-Burgmann; Yun-Yi Hung; Walter Kinney
Among women older than 50 years with complex adnexal masses of 6 cm or less, risk
of malignancy was low, and all epithelial cancers were detected by 7 months of
ultrasound follow-up.

625 Management of stage Ia1 squamous cervical cancer and the importance
of excision margins: a retrospective study of long-term outcome
after 25 years of follow-up
Katerina Papakonstantinou; Maria Kyrgiou; Deidre Lyons;
William P. Soutter; Sadaf Ghaem-Maghami
The role of excision margins and management of stage Ia1 squamous cell cancer is
addressed.
(continued on page 5A)

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R ESEARCH (continued from page 2A)

627 The influence of comorbid conditions on racial disparities in endometrial

cancer survival
Julie J. Ruterbusch; Rouba Ali-Fehmi; Sara H. Olson; Shawnita Sealy-Jefferson;
Benjamin A. Rybicki; Sharon Hensley-Alford; Mohamed A. Elshaikh;
Arthur R. Gaba; Daniel Schultz; Adnan R. Munkarah; Michele L. Cote
The higher mortality rate from endometrial cancer in black women cannot be
explained fully by known predictors of survival or the higher prevalence of comorbid
conditions.

630 Maternal adaptations in preparation for parturition predict

uncomplicated spontaneous delivery outcome
Sallie S. Oliphant; Ingrid E. Nygaard; Wenjun Zong;
Timothy P. Canavan; Pamela A. Moalli
High first-trimester elastase activity and third-trimester vaginal descent are
associated with an increased likelihood of uncomplicated spontaneous vaginal birth.

632 Prognostic role and predictors of complete pathologic response to

neoadjuvant chemotherapy in primary unresectable ovarian cancer
Marco Petrillo; Gian Franco Zannoni; Lucia Tortorella; Luigi Pedone Anchora;
Vanda Salutari; Alfredo Ercoli; Pasquale Alessandro Margariti;
Giovanni Scambia; Anna Fagotti
We demonstrate the prognostic relevance of an easily assessable classification of
pathological response to neoadjuvant chemotherapy in a large retrospective series of
unresectable ovarian cancer patients, and we strongly emphasize the prognostic
relevance of complete pathological response to neoadjuvant chemotherapy.

635 Evidence of mononuclear cell preactivation in the fasting state in

polycystic ovary syndrome
Frank González; John P. Kirwan; Neal S. Rote; Judi Minium
Mononuclear cells of women with polycystic ovary syndrome are preactivated as
evidence by increased cytokine secretion following lipopolysaccharide exposure in
the fasting state.

637 Nomogram to predict recurrence in patients with early- and

advanced-stage mucinous and serous borderline ovarian tumors
Sofiane Bendifallah; Marcos Ballester; Catherine Uzan; Raffaele Fauvet;
Philippe Morice; Emile Darai
A nomogram based on 5 clinical and pathological characteristics to predict
recurrence probability had high concordance and may be useful to better
inform the patient.

OBSTETRICS

639 Screening approach for gestational diabetes in twin pregnancies

Andrei Rebarber; Cara Dolin; Jessica C. Fields; Daniel H. Saltzman;
Chad K. Klauser; Simi Gupta; Nathan S. Fox
In twin pregnancies, the optimal glucose challenge test cutoff appears to be

135 mg/dL.
(continued)

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R ESEARCH (continued)

641 Use of hemoglobin A1c as an early predictor of

gestational diabetes mellitus
Alex Fong; Allison E. Serra; Lauryn Gabby;
Deborah A. Wing; Kathleen M. Berkowitz
Patients with early screening hemoglobin A1c value of 5.7-6.4% have >2-fold higher
rates of the development of gestational diabetes mellitus compared with those
patients with a hemoglobin A1c value of <5.7%.

644 Interpreting category II fetal heart rate tracings: does meconium matter?
Heather A. Frey; Methodius G. Tuuli; Anthony L. Shanks;
George A. Macones; Alison G. Cahill
Among women with a category II fetal heart rate tracing, meconium is associated
with an increased risk of neonatal morbidity.

647 Performance of racial and ethnic minority-serving hospitals on

delivery-related indicators
Andreea A. Creanga; Brian T. Bateman; Jill M. Mhyre; Elena Kuklina;
Alexander Shilkrut; William M. Callaghan
Primarily black-serving hospitals in the United States perform considerably worse on
delivery-related indicators than primarily white- or Hispanic-serving hospitals.

651 Uptake of noninvasive prenatal testing at a large

academic referral center
Sebastian Larion; Steven L. Warsof; Letty Romary; Margaret Mlynarczyk;
David Peleg; Alfred Z. Abuhamad
Noninvasive prenatal testing had high uptake among our high-risk patients and
decreased the number of diagnostic tests within a short period of time.
See related editorial, page 577

654 Maternal obesity and gestational diabetes are associated with placental
leptin DNA methylation
Corina Lesseur; David A. Armstrong; Alison G. Paquette; Zhigang Li;
James F. Padbury; Carmen J. Marsit
Maternal prepregnancy obesity and gestational diabetes influence infant DNA
methylation patterns of the leptin promoter in human placenta.

657 A population-based study of associations between preeclampsia and

later cardiovascular risk factors
Ingvild V. Alsnes; Imre Janszky; Michele R. Forman;
Lars J. Vatten; Inger Økland
Women with a history of mild and moderate preeclampsia but not severe
preeclampsia may be at increased risk of cardiovascular disease.

660 The mortality risk of expectant management compared with delivery

stratified by gestational age and race and ethnicity
Melissa G. Rosenstein; Jonathan M. Snowden;
Yvonne W. Cheng; Aaron B. Caughey
The mortality risk of expectant management exceeds the mortality risk of delivery at
39 weeks in all racial/ethnic groups, despite variation in absolute risks.
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R ESEARCH (continued from page 6A)

662 Does pregnancy and/or shifting positions create more room in a

woman’s pelvis?
Anke Reitter; Betty-Anne Daviss; Andrew Bisits; Astrid Schollenberger;
Thomas Vogl; Eva Herrmann; Frank Louwen; Stephan Zangos
Magnetic resonance imaging pelvimetry shows a significant increase of the transverse
mid pelvis and the pelvic outlet when women change from supine dorsal to kneeling
squat position.

665 Effect of maternal intravenous fluid therapy on external cephalic version

at term: a prospective cohort study
Jorge Burgos; Eider Quintana; Patricia Cobos; Carmen Osuna;
Marı́a del Mar Centeno; Juan Carlos Melchor
Maternal intravenous fluid therapy with 2 L of hypotonic saline prior to external
cephalic version does not increase the success rate of the procedure.

667 Neonatal encephalopathy and the association to asphyxia in labor

Maria Jonsson; Johan Ågren; Solveig Nordén-Lindeberg;
Andreas Ohlin; Ulf Hanson
Neonatal encephalopathy is related strongly to asphyxia in labor.

669 A comparison of Doppler and biophysical findings between liveborn and

stillborn growth-restricted fetuses
Sarah Crimmins; Andrea Desai; Dana Block-Abraham; Christoph Berg;
Ulrich Gembruch; Ahmet Alexander Baschat
Although abnormalities that are found on multiple Doppler and biophysical
examination herald stillbirth in preterm fetal growth restriction, only brain-sparing
precedes stillbirth at >34 weeks of gestation.

672 Quality of first-trimester measurement of crown-rump length

Ferdinand Dhombres; Babak Khoshnood; Roger Bessis; Nicolas Fries;
Marie-Victoire Senat; Jean-Marie Jouannic
High scores for the quality of the nuchal translucency measurement at the first-
trimester scan do not guarantee accurate measurement of crown-rump length.

675 Risk of selected structural abnormalities in infants after increased

nuchal translucency measurement
Rebecca J. Baer; Mary E. Norton; Gary M. Shaw; Monica C. Flessel;
Sara Goldman; Robert J. Currier; Laura L. Jelliffe-Pawlowski
Increased nuchal translucency is associated with increased risk of pulmonary,
gastrointestinal, genitourinary, and musculoskeletal birth defects among
liveborn euploid infants without cardiac defects.

678 Maternal serum serpin B7 is associated with early spontaneous

preterm birth
Samuel Parry; Heping Zhang; Joseph Biggio; Radek Bukowski; Michael Varner;
Yaji Xu; William W. Andrews; George R. Saade; M. Sean Esplin; Rita Leite;
John Ilekis; Uma M. Reddy; Yoel Sadovsky; Ian A. Blair; for the Eunice Kennedy
Shriver National Institute of Child Health and Human Development Genomic
and Proteomic Network for Preterm Birth Research
Semiquantitative proteomics analyses using second-trimester maternal serum
samples associated serpin B7 with early spontaneous preterm delivery.
(continued)

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R ESEARCH (continued)

681 Hydatidiform mole and subsequent pregnancy outcome: a

population-based cohort study
Ulrika Joneborg; Sandra Eloranta; Anna L. V. Johansson; Lena Marions;
Caroline E. Weibull; Mats Lambe
The risk of subsequent adverse pregnancy maternal and offspring outcomes is very
low among women with a history of hydatidiform mole.

684 Blunt versus sharp uterine incision expansion during low transverse
cesarean delivery: a metaanalysis
Antonio F. Saad; Mahbubur Rahman; Maged M. Costantine; George R. Saade
During cesarean delivery, blunt uterine incision expansion is associated with
lower drop in blood count, lower incidence in unintended extensions, and
shorter operative time.

686 Placental expression of aminopeptidase-Q (laeverin) and its role in the

pathophysiology of preeclampsia
Mona Nystad; Vasilis Sitras; Merethe Larsen; Ganesh Acharya
Aminopeptidase-Q (laeverin) is a 60-kDa protein that is expressed in the cytosol of
trophoblasts and in microvesicles and leaks into the fetal capillaries in preeclamptic
placentas.

688 Calcium-activated chloride channels anoctamin 1 and 2 promote murine

uterine smooth muscle contractility
Kyra Bernstein; Joy Y. Vink; Xiao Wen Fu; Hiromi Wakita;
Jennifer Danielsson; Ronald Wapner; George Gallos
Pharmacologic blockade of myometrial calcium activated chloride channels
anoctamin1 and 2 causes myometrial relaxation, inhibition of spontaneous
transient inward currents, and suppression of agonist induced calcium flux.

690 Trends in pregnancy labeling and data quality for

US-approved pharmaceuticals
Maryann Mazer-Amirshahi; Samira Samiee-Zafarghandy;
George Gray; Johannes N. van den Anker
Despite efforts to improve pharmaceutical labeling in pregnancy, there remains a
paucity of data regarding the safe and effective use of medication in this population.

692 The relationship between obstetricians’ cognitive and affective traits and
their patients’ delivery outcomes
Lynn M. Yee; Lilly Y. Liu; William A. Grobman
Although patients delivered by physicians with more adaptive coping skills had a
decreased risk of operative vaginal delivery, other cognitive and affective traits were
associated with an increased risk of chorioamnionitis and hemorrhage.

695 Screening practices and attitudes of obstetricians-gynecologists toward

new and emerging tobacco products
Lucinda Jane England; Britta Louise Anderson; Van Thi Ky Tong;
Jeanne Mahoney; Victoria Hope Coleman-Cowger;
Paul Melstrom; Jay Schulkin
Obstetrician-gynecologists reported inconsistently screening their pregnant patients
for use of noncombustible tobacco products, and most respondents wanted more
information on health effects for pregnant women.

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R ESEARCH (continued from page 9A)

698 Assessing preventability of maternal mortality in Illinois: 2002-2012

Stacie E. Geller; Abigail R. Koch; Nancy J. Martin; Deborah Rosenberg;
Harold R. Bigger; for the Illinois Department of Public Health
Maternal Mortality Review Committee Working Group
A retrospective review of 610 maternal deaths in Illinois from 2002 through 2012
found 34.4% (n ¼ 210) related to pregnancy, 32.4% (n ¼ 68) of which were
potentially preventable.
See related editorial, page 581

700 Mode of delivery in women with class III obesity: planned cesarean
compared with induction of labor
Akila Subramaniam; Victoria Chapman Jauk; Amy Reed Goss;
Mitchell Dean Alvarez; Crystal Reese; Rodney Kirk Edwards
In women with class III obesity, there are no significant differences in maternal or
neonatal morbidity between planned cesarean delivery and induction of labor.

EDUCATION

703 The relationship between a reviewer’s recommendation and editorial

decision of manuscripts submitted for publication in obstetrics
Anthony M. Vintzileos; Cande V. Ananth; Anthony O. Odibo;
Suneet P. Chauhan; John C. Smulian; Yinka Oyelese
The degree of influence of reviewer’s recommendation on the final disposition
of obstetrical manuscripts depends on the type of recommendation.

S URGEON ’ S C ORNER
706 Loop electrosurgical excision procedure
R. Shae Connor; A. Mitch Dizon; Kristopher J. Kimball
We describe a durable, cost-effective simulation model for teaching loop
electrosurgical excision procedure that can be easily constructed for less
than $10 (US).

L ETTERS TO THE E DITORS

708 Amniotic fluid infection, inflammation, and colonization in preterm labor
with intact membranes
Teresa Cobo; Marian Kacerovsky; Bo Jacobsson
Reply, page 708
C. Andrew Combs; Michael Gravett; Thomas J. Garite

709 The relationship between primary cesarean delivery skin incision type
and wound complications in women with morbid obesity: a response
Geoffrey H. Gordon; Robert A. Welch
Reply, page 710
Caroline C. Marrs; Sean C. Blackwell

710 Re: The debate over robotics in benign gynecology

W. Scott Walker
Reply, page 711
Charles R. Rardin
(continued)

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711 Noninvasive prenatal screening for fetal trisomies 21, 18, 13 and the
common sex chromosome aneuploidies from maternal blood using
massively parallel genomic sequencing of DNA
Francesca R. Grati; Jose C. P. B. Ferreira; Komal Bajaj
Reply, page 712
Richard P. Porreco

713 Maternal mortality in the United States: predictability and the impact
of protocols on fatal postcesarean pulmonary embolism and
hypertension-related intracranial hemorrhage
Leo R. Brancazio
Reply, page 713
Steven L. Clark; James T. Christmas

713 Complications following “Brazilian” waxing for pubic hair removal

Laxmi V. Baxi; Margaret Dziadosz

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