Eyal Sheiner

Ben-Gurion University of the Negev, Be'er Sheva`, Southern District, Israel

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Publications (433)700.75 Total impact

  • Jamie Klein, Ron Charach, Eyal Sheiner
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    ABSTRACT: Introduction: Gestational diabetes mellitus (GDM), defined as glucose intolerance with first recognition or onset during pregnancy, is steadily rising in prevalence. GDM affects ∼ 3 - 5% of pregnancies in the US and is associated with significant adverse perinatal and maternal outcomes. Diagnosing and treating GDM early in pregnancy is of utmost importance as it can prevent poor outcomes such as macrosomia, shoulder dystocia and obstetric complications. Areas covered: This review describes the importance of treating GDM and the various available interventions for glycemic control in women with GDM, including the latest evidence regarding pharmacological treatments and specifically anti-hyperglycemic agents. It deals with timing of pharmacological treatments, recommended doses and what pharmacological agent should be used. Expert opinion: Unless diagnosed late during pregnancy, a stepwise approach is the best way to treat GDM, beginning with diet and exercise and proceeding to pharmacological interventions if failure occurred. Although insulin is the dominant treatment, the use of anti-hyperglycemic agents such as glyburide and metformin in treating GDM has gained popularity and consideration should be made using these agents as first-line pharmacological treatment. Anti-hyperglycemic agents do not require frequent monitoring or injections and may therefore appeal more to patients. Further studies are needed regarding long-acting insulin and other anti-hyperglycemic agents such as thiazolidinediones, as well as identifying treatment options more specific to an individual based on risk factors and other variables predicting treatment outcomes in GDM.
    Expert Opinion on Pharmacotherapy 11/2014; · 2.86 Impact Factor
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    ABSTRACT: Abstract Objective: To determine the reproductive outcome following hysteroscopic septum resection in women with a septated uterus and a history of spontaneous miscarriages or premature deliveries. Study Design: A retrospective, cohort study investigating reproductive outcomes following septum resection was conducted. Patients who had no other apparent cause for spontaneous miscarriage or preterm delivery were included in the study. Reproductive outcomes were compared between pregnancies prior to and after the septum resection. Multiple pregnancies were excluded. Results: Twenty-eight patients met the inclusion criteria with a total of 85 pregnancies, 45 prior and 40 after septectomy. The mean gestational age increased from 33.73±6.27 (weeks) prior to the resection to 38.47±1.71 (weeks) after it (p<0.05). The mean birth-weight increased from 2520±764.4 (grams) to 3202.6±630.2 (grams) after the resection. Spontaneous miscarriage rate dropped from 63.6% to 12.5%. Multivariate analysis models showed uterine septectomy to be independently associated with increased gestational age at delivery (Beta=0.606, Adjusted R(2)=0.328, CI 10.647-20.612, P<0.01), increased birth weight (Beta=0.424, Adjusted R(2)= 0.129, CI 202.097-1210.287, P<0.01) and with lower risk for preterm delivery (OR=0.073, CI 0.16-0.327, P<0.01). Conclusion: Hysetroscopic resection of a uterine septum improves reproductive outcomes in women with a septated uterus and a history of spontaneous miscarriages or premature deliveries.
    Journal of Maternal-Fetal and Neonatal Medicine. 10/2014;
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    ABSTRACT: Abstract Objective: To investigate the association between anemia during pregnancy and subsequent future maternal cardiovascular morbidity and mortality. Methods: A retrospective cohort study was conducted, comparing women with and without anemia during pregnancy. Deliveries occurred during 1988-1998 and had followed for more than a decade. Incidence of long-term cardiovascular morbidity was compared between the two groups. Results: During the study period, 47,657 deliveries met the inclusion criteria; of these 12,362 (25.9%) occurred in women with anemia at least once during their pregnancies. Anemia of pregnancy was noted as a risk factor for long-term complex cardiovascular events (OR=1.6, 95% CI 1-2.8, P=0.04). Using Cox multivariable regression model, controlling for ethnicity and maternal age, anemia was found to be an independent risk factor for long-term maternal cardiovascular hospitalization (OR for total hospitalizations=1.2, 95%CI 1.1-1.4, p<0.001). Conclusion: Anemia of pregnancy is an independent risk factor for long-term cardiovascular morbidity in a follow-up period of more than a decade.
    Journal of Maternal-Fetal and Neonatal Medicine. 10/2014;
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    ABSTRACT: To evaluate blood flow Doppler velocimetry during the first and second stages of active labor.
    Archives of Gynecology and Obstetrics 09/2014; · 1.33 Impact Factor
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    ABSTRACT: Abstract Objective: To investigate whether patients with a history of placental abruption have an increased risk for subsequent maternal long-term morbidity. Study design: A population-based study compared the incidence of long-term renal morbidity in cohort of women with and without a history of placental abruption. Deliveries occurred during a 25 years period, with a mean follow-up duration of 11.2 years. Renal morbidity included kidney transplantation, chronic renal failure, hypertensive renal disease etc. Results: During the study period 99,354 deliveries met the inclusion criteria; 1.8% (n=1807) occurred in patients with a diagnosis of placental abruption. Patients with placental abruption did not have higher cumulative incidence of renal related hospitalizations, using Kaplan-Meier survival curve. During the follow-up period patients with a history of placental abruption did not have higher rate of renal morbidity (0.2% vs. 0.1%; OR 1.8; 95% CI 0.6-4.8; P=0.261). When performing a Cox proportional hazards model, adjusted for confounders such as parity and diabetes mellitus, a history of placental abruption was not associated with renal related hospitalizations (adjusted HR,1.6; 95% CI, 0.6-4.2; P=0.381). Conclusion: Placental abruption, even though considered a part of the "placental syndrome" with possible vascular etiology, is not a risk factor for long-term maternal renal complications.
    Journal of Maternal-Fetal and Neonatal Medicine. 09/2014;
  • Aubrey Raimondi, Eyal Sheiner
    Evidence-based nursing. 09/2014;
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    ABSTRACT: To investigate whether visually impaired women are at higher risk for adverse maternal and perinatal complications, with an emphasis on visual impairment due to autoimmune etiology.
    Archives of Gynecology and Obstetrics 08/2014; · 1.33 Impact Factor
  • Natalie Shalit, Roy Shalit, Eyal Sheiner
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    ABSTRACT: Abstract Objective: To determine the effect of the Day of Atonement fast (a 25 hours Jewish fast), on preterm delivery. Methods: A comprehensive analysis of all deliveries during the Day of Atonement and during the corresponding day a week earlier, between the years 1988-2011, was performed. Preterm delivery was defined as delivery before 37 completed weeks of gestation. Data on fasting status was deduced from the ethnicity (as only Jewish parturients fast during the Day of Atonement). Multivariable logistic regression model was used to control for confounders. Results: During the Day of Atonement in the studied period, 745 deliveries took place, out of which 52.1% (n=388) were of Jewish patients (i.e. fasting group), and 47.9% (n=357) were of non-Jewish patients. Out these, 6.3% (n=47) were preterm deliveries. Jewish parturients were at significantly higher risk for preterm delivery during the Day of Atonement (adjusted OR=1.99; 95% CI, 1.03-3.83; P=0.041). In the corresponding day, a week before the Day of Atonement, Jewish ethnicity was not found to be a risk factor for preterm delivery (OR=0.92; 95% CI, 0.50-1.69; P=0.789). The model controlled for: previous preterm delivery, intrauterine growth restriction and placental abruption . Conclusions: A 25 hours fast is an independent risk factor for preterm delivery.
    Journal of Maternal-Fetal and Neonatal Medicine. 08/2014;
  • Kent Willis, Nicky Lieberman, Eyal Sheiner
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    ABSTRACT: The global obesity epidemic is changing the face of maternal-fetal medicine. One in five women are obese at time of conception, and increasing numbers of parturients have undergone bariatric surgery. Recent publication of large, population-based studies and comparison studies of preoperative and postoperative pregnancies have highlighted new risks and benefits to mother and child. Pregnancy after bariatric surgery appears to effectively reduce the risk of complications such as fetal macrosomia, gestational diabetes mellitus and hypertensive disorders of pregnancy, however, women who become pregnant after bariatric surgery may constitute a unique obstetric population with an increased risk for preterm and small-for-gestational-age infants. In this article, we provide an overview of the current knowledge of the impact of maternal bariatric surgery on neonatal and pregnancy outcomes.
    Best Practice & Research Clinical Obstetrics & Gynaecology. 08/2014;
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    ABSTRACT: To investigate whether women who experienced at least one stillbirth are at increased risk for subsequent maternal long-term atherosclerotic morbidity.
    American journal of obstetrics and gynecology. 07/2014;
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    ABSTRACT: Abstract Objective: To investigate risk factors for postpartum hemorrhage (PPH) in vaginal deliveries and the influence of previous PPH on the subsequent pregnancy. Study design: A retrospective cohort study including first singleton deliveries between the years 1988 and 2012 was performed comparing deliveries with and without PPH. In addition, perinatal outcomes of the subsequent pregnancy were evaluated. Multivariable analysis was performed to control for confounders. Results: PPH complicated 0.8% of all first vaginal deliveries. Significant risk factors for PPH in vaginal delivery, using a multiple logistic regression model, were: post-term pregnancy, fertility treatments, hypertensive disorders, labor dystocia during the 2nd, and perineal tears grade 2 and 3 respectively. Previous PPH was found to be an independent risk factor for PPH in the subsequent pregnancy. Moreover, previous PPH was found to be a significant risk factor for CS deliver, to complicate delivery with revision of uterus cavity, anemia, and to require blood transfusion. Conclusion: Previous PPH poses a risk for recurrent PPH in subsequent delivery and an increased risk for CS. As PPH remains one of the major causes of maternal morbidity, this study strengthens the need for a comprehensive evaluation of prior PPH as a major risk factor for PPH recurrence.
    Journal of Maternal-Fetal and Neonatal Medicine. 07/2014;
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    ABSTRACT: Abstract Objectives: To investigate parturients at risk to develop venous thrombo-embolic events (VTE) in the puerperium or later in life, during a follow-up of more than a decade , and compare risk factors for VTE during the puerperium with VTE later in life. Methods: A nested case-control study was conducted to profile parturients at risk for VTE and a secondary analysis to compare risk factors for VTE during or after puerperium. We used a cohort of 95,257 women that gave birth between the years 1988-1998. Results: Independent risk factors to develop VTE were peripartum hysterectomy, stillbirth, cesarean delivery (CD), obesity,pregnancy related hypertension, grandmultiparity and advanced maternal age. Women undergoing CD and these receiving blood transfusion were more likely to develop early vs. late VTE (OR=2.0, 95% Cl=1.15-3.5, and OR=11.0, 95% Cl=2.25-55.5; respectively.(Patients that encountered VTE during the puerperium had more pulmonary emboli and less deep vein thrombosis , compared with the late VTE group (p< 0.001). Conclusions: Maternal age, grandmultiparity, pregnancy related hypertension, CD, obesity, stillbirth and peripartum hysterectomy are independent risk factors for the development of VTE. CD and blood transfusion were predictive of early vs. late VTE.
    Journal of Maternal-Fetal and Neonatal Medicine. 07/2014;
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    ABSTRACT: Abstract Objective: To establish whether failure to progress during labor poses a risk factor for another non-progressive labor (NPL) during the subsequent delivery. Methods: A retrospective cohort study including singleton pregnancies that failed to progress during the previous labor and resulted in a CS was conducted. Parturients were classified into three groups for both previous and subsequent labors: CS due to NPL stage I, stage II and an elective CS as a comparison group. Results: Out of 202,462 deliveries, 10,654 women met the inclusion criteria: 3,068 women were operated due to NPL stage I and 1218 due to NPL stage II; The comparison group included 6368 women. Using a multivariable logistic regression models, NPL stage I during the previous delivery was found as an independent risk factor for another NPL stage I in the subsequent labor (adjusted OR=2.9; 95% CI=2.4-3.7; p<0.001). Similarly, NPL at stage I or II was found to be an independent risk factor for a NPL stage II during the subsequent labor (adjusted OR=1.4; 95% CI=1.1-2.1; p=0.033; adjusted OR=5.3; 95% CI=3.7-7.5; p<0.001; respectively). Conclusion: A previous CS due to a NPL is an independent risk factor for another NPL in the subsequent pregnancy and for recurrent cesarean delivery.
    Journal of Maternal-Fetal and Neonatal Medicine. 07/2014;
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    ABSTRACT: To investigate whether patients with a history of recurrent pregnancy loss (RPL) have an increased risk for future maternal atherosclerotic morbidity.
    American journal of obstetrics and gynecology. 06/2014;
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    ABSTRACT: Abstract Objective: To examine possible correlation between α1-antitrypsin (AAT) levels and activity in patients with and without obesity, after excluding complications such as gestational diabetes mellitus (GDM), during pregnancy. Study design: A prospective case-control study was conducted. AAT levels were determined by standard human AAT ELISA according to the manufacturer's instructions. Elastase inhibition was determined by kinetic assay according to manufacturer recommendations. Assays were performed in duplicates and repeated twice for each sample in separate sessions. Patients with diabetes mellitus were excluded from the study. Mann-Whitney U-test was performed in order to determine statistical differences between the groups, and AAT concentration and activity. Results: During the study period 43 patients were recruited: 21 with isolated obesity and 22 non-obese parturients (control group). According to ELISA, AAT concentrations were mildly lower in obese women compared to non-obese women (8.31 ± 0.28 mg/ml vs. 9.5 ± 0.37 mg/ml, p=0.0155). However, elastase inhibitory capacity was markedly lower in obese vs. non-obese parturients (mean 27.33 ± 2.08 % vs. 43.73 ± 3.1%, p<0.001). Conclusions: Isolated obesity in pregnancy is associated with lower activity of AAT. These findings correlate with the reduced concentration and activity of AAT found in patients with GDM. Accordingly, it might suggest an inflammatory axis shared by obesity and the development of insulin resistance.
    Journal of Maternal-Fetal and Neonatal Medicine. 05/2014;
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    ABSTRACT: To determine whether women with a previous uterine scar dehiscence are at increased risk of adverse perinatal outcomes in the following delivery. A retrospective cohort study was conducted of all subsequent singleton cesarean deliveries performed at the Soroka University Medical Center, Beer-Sheva, Israel, between January 1, 1988, and December 31, 2011. Clinical and demographic characteristics, maternal obstetric complications, and fetal complications were evaluated among women with or without a previous documented uterine scar dehiscence. Of the 5635 pregnancies associated with at least two previous cesarean deliveries, 180 (3.2%) occurred among women with a previous uterine scar dehiscence. Women with this condition in a prior pregnancy were more likely than those without previous uterine scar dehiscence to experience subsequent preterm delivery (86 [47.8%] vs 1350 [24.7%]; P<0.001), low birth weight (47 [26.1%] vs 861 [15.8%]; P<0.001), and peripartum hysterectomy (5 [2.8%] vs 20 [0.4%]; P<0.001). Nevertheless, previous uterine scar dehiscence did not increase the risk of uterine rupture, placenta accreta, or adverse perinatal outcomes, such as low Apgar scores at 5minutes and perinatal mortality. Uterine scar dehiscence in a previous pregnancy is a potential risk factor for preterm delivery, low birth weight, and peripartum hysterectomy in the following pregnancy.
    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 04/2014; · 1.41 Impact Factor
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    ABSTRACT: Background To evaluate the role of umbilical artery (UA) peak systolic velocity (PSV) measurements in the prediction of perinatal outcome in fetuses with intrauterine growth restriction (IUGR). MethodsA prospective study was performed, including patients with a suspected diagnosis of IUGR. Exclusion criteria were multiple gestations, unreliable gestational age, and known fetal malformations. Doppler measurements of the UA and middle cerebral artery (MCA) were recorded. ResultsSeventy-two patients were enrolled and a total of 192 Doppler measurements were performed between 24 and 39 weeks' gestation. Mean gestational age at delivery was 36.9 ± 2.7 days and mean birth weight was 2,166 ± 497 grams. Nine patients (12.5%) had oligohydramnios; 50 (69.4%) delivered preterm (<37 weeks), and 26 underwent a cesarean section, of those 7 (29.2%) cesarean sections were for a nonreassuring fetal heart rate tracing. Fifty-one (70.8%) neonates were actually small for gestational age. No correlation was found between UA-PSV and MCA-PSV to perinatal outcome. Correlation was found between UA pulsatility index and cerebroplacental ratio to perinatal outcome before 34 weeks' gestation. ConclusionsUA PSV measurements do not correlate with adverse perinatal outcome. A correlation exists between UA pulsatility index and cerebroplacental ratio and perinatal outcome prior to 34 weeks' gestation. It seems that UA PSV and MCA PSV do not contribute to the management of fetuses with IUGR. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound, 2014
    Journal of Clinical Ultrasound 03/2014; · 0.70 Impact Factor
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    ABSTRACT: Objective: To examine the association between calcium levels during the first trimester of pregnancy and preeclampsia. Methods: The study population included registered births (n = 5233) in a tertiary medical center between 2001 and 2011. A comparison was performed between women with and without hypocalcemia during the first trimester of pregnancy. A second analysis was performed after correcting calcium levels for albumin. Multiple logistic regression models were used to control for confounders. Receiver operating characteristic curve analysis graphs were used to describe the relationship between the true-positive rate (sensitivity) and the false-positive rate for different values of calcium during the first half of pregnancy in the prediction of preeclampsia. Results: Of 5233 deliveries, 841 (16%) had hypocalcemia and 4392 (84%) had a normal calcium level. No significant difference were found between the groups regarding mild preeclampsia [odds ratio (OR) = 1.216; 95% confidence interval (CI) 0.831-1.779; p = 0.312], severe preeclampsia (OR = 1.618; 95% CI 0.919-2.849; p = 0.092) and any hypertensive disorders (OR = 1.324; 95% CI 0.963-1.821; p = 0.083). Conclusions: Hypocalcemia during the first trimester of pregnancy is not a risk factor for preeclampsia.
    Hypertension in Pregnancy 01/2014; · 0.93 Impact Factor
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    ABSTRACT: Objective To determine whether women with a previous uterine scar dehiscence are at increased risk of adverse perinatal outcomes in the following delivery. Methods A retrospective cohort study was conducted of all subsequent singleton cesarean deliveries performed at the Soroka University Medical Center, Beer-Sheva, Israel, between January 1, 1988, and December 31, 2011. Clinical and demographic characteristics, maternal obstetric complications, and fetal complications were evaluated among women with or without a previous documented uterine scar dehiscence. Results Of the 5635 pregnancies associated with at least two previous cesarean deliveries, 180 (3.2%) occurred among women with a previous uterine scar dehiscence. Women with this condition in a prior pregnancy were more likely than those without previous uterine scar dehiscence to experience subsequent preterm delivery (86 [47.8%] vs 1350 [24.7%]; P < 0.001), low birth weight (47 [26.1%] vs 861 [15.8%]; P < 0.001), and peripartum hysterectomy (5 [2.8%] vs 20 [0.4%]; P < 0.001). Nevertheless, previous uterine scar dehiscence did not increase the risk of uterine rupture, placenta accreta, or adverse perinatal outcomes, such as low Apgar scores at 5 minutes and perinatal mortality. Conclusion Uterine scar dehiscence in a previous pregnancy is a potential risk factor for preterm delivery, low birth weight, and peripartum hysterectomy in the following pregnancy.
    International Journal of Gynecology & Obstetrics. 01/2014;
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    ABSTRACT: Abstract Objectives: To determine the effect of cervical cerclage on obstetrical complications and perinatal outcomes of patients following conization. Design: A retrospective population based cohort study Setting: Tertiary academic medical center that covers all the deliveries of the region Population: All patients with previous cervical conization who delivered between the years 1994-2011. Methods: A retrospective population based study. Main outcome measures: the effect of cerclage placement on the rate of preterm birth. Results: During the study period there were 109 deliveries of patients following a cervical conization. Cervical cerclage was placed in 22 deliveries that served as the study group and the rest (n=87) served as the comparison group. The rate of early preterm delivery (PTD; <34 weeks) was significantly higher in women who had a cerclage. In a logistic regression model cerclage was found to be an independent risk factor for early PTD. Conclusion: Cerclage is an independent risk factor for early PTD In patients who had a conization due to CIN.
    The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 12/2013; · 1.36 Impact Factor

Publication Stats

3k Citations
700.75 Total Impact Points

Institutions

  • 1998–2014
    • Ben-Gurion University of the Negev
      • • Division of Obstetrics and Gynecology
      • • Department of Radiology
      • • Shraga Segal Department of Microbiology and Immunology
      • • Division of Anesthesiology
      • • Faculty of Health Sciences
      Be'er Sheva`, Southern District, Israel
  • 2000–2013
    • Soroka Medical Center
      • • Division of Obstetrics and Gynecology
      • • Department of Internal Medicine
      Be'er Sheva`, Southern District, Israel
  • 2012
    • Hillel Yaffe Medical Center
      Hědērā, Haifa District, Israel
  • 2005–2011
    • Rush University Medical Center
      • • Division of Pharmacology
      • • Department of Obstetrics and Gynecology
      Chicago, IL, United States
  • 2008
    • Loyola University Maryland
      Baltimore, Maryland, United States
  • 2007
    • University of Chicago
      • Department of Obstetrics & Gynecology
      Chicago, IL, United States