Catherine Bigelow

Massachusetts General Hospital, Boston, Massachusetts, United States

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Publications (9)30.13 Total impact

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    ABSTRACT: Objectives Preterm premature rupture of the membranes (PPROM) is spontaneous rupture of membranes before 37 weeks' gestation before the onset of labor. The standard of care is inpatient management with antibiotics and monitoring. Bed rest has not been shown to be beneficial in the setting of PPROM and has adverse maternal effects. We conducted a pilot randomized clinical trial (RCT) to determine the feasibility of recruitment for an RCT of this nature and obtain estimates of the frequency of maternal and neonatal outcomes. Study Design Patients who were diagnosed with PPROM < 34 weeks gestational age were randomized to bed rest versus activity in a 1:1 ratio. Subjects in both groups wore pedometers and kept activity logs. Maternal demographic and obstetric data and neonatal outcomes were collected and compared between groups using chi-square and Fisher exact tests. Latency was evaluated with log-rank test and Kaplan-Meier analysis. Results In this study, 36 women were enrolled and randomized; 1 patient withdrew. Complete data were available for 21 subjects. In univariable analysis, women in the activity group had a nonsignificantly shorter latency time than the bed rest group (median 6.0 vs. 8.5 days). Neonatal outcomes were similar between groups. Using log-rank sum analysis, neonates born to mothers in the activity group were more likely to develop necrotizing enterocolitis (NEC) than in the control group (24 vs. 0%, p = 0.05); this difference was not significant after false discovery rate correction (p = 0.80). Conclusion This is the first randomized controlled study to evaluate bed rest versus normal activity in the setting of PPROM < 34 weeks. This study demonstrates a nonsignificant increase in latency to delivery on bed rest and possible increase in NEC in the activity group; the mechanism remains unclear. We would recommend a larger RCT to better clarify these findings.
    American Journal of Obstetrics and Gynecology 01/2015; 212(1):S378. DOI:10.1016/j.ajog.2014.10.986 · 4.70 Impact Factor
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    ABSTRACT: Objective To determine if selective termination (ST) of an anomalous dichorionic twin at early gestational age (GA) is associated with a decreased risk of fetal loss and prematurity.Method All patients who had ST for dichorionic twin pregnancies from 2004 through 2010 at Mount Sinai Medical Center were included. Data was collected via chart review and patient interview. Two case–control analyses were done: firstly, cases were nonviable deliveries and controls were live-births, and, secondly, cases were live births <37 weeks GA and controls were live births ≥37 weeks GA. Univariable then multivariable analysis identified characteristics associated with pregnancy loss and prematurity.ResultsAmong 80 participants, there were 4 (5%) fetal losses and 15 (19%) premature births. GA at ST was the only characteristic associated with pregnancy loss in multivariable exact logistic regression [OR = 1.43, 95%CI (1.03, 2.26), P = .03]. GA at ST was the only characteristic associated with premature delivery in multivariable exact logistic regression [OR = 1.18, 95%CI (1.02, 1.37), P = .03].Conclusion This study suggests that ST performed earlier in pregnancy is associated with decreased fetal loss and prematurity. This article is protected by copyright. All rights reserved.
    Prenatal Diagnosis 12/2014; 34(13). DOI:10.1002/pd.4474 · 3.27 Impact Factor
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    ABSTRACT: Risk factors for the development of new-onset late postpartum preeclampsia (LPP) in women without any history of preeclampsia are not known. Because identification of women at risk may lead to earlier diagnosis of disease and improved maternal outcomes, this study identified risk factors (associated patient characteristics) for new-onset LPP. A case-control study of 34 women with new-onset LPP after normal delivery and 68 women without new-onset LPP after normal delivery, matched on date of delivery, was conducted at Mount Sinai Hospital, New York City. Data was collected via chart review. Exact conditional logistic regression identified patient characteristics associated with new-onset LPP. New-onset LPP was associated with age ≥ 40 years [AOR = 24.83, 95% CI (1.43, infinity), P = .03], black race [AOR = 78.35, 95% CI (7.25, infinity), P < .001], Latino ethnicity [AOR = 19.08, 95% CI (2.73, infinity), P = .001], final pregnancy BMI ≥ 30 [AOR = 13.38, 95% CI (1.87, infinity), P = .01], and gestational diabetes [AOR = 72.91, 95% CI (5.52, infinity), P < .001]. As predictive tests for new-onset LPP, the sensitivity and specificity of having 1 or more of these characteristics was 100% and 59%, respectively, and the sensitivity and specificity of having 2 or more was 56% and 93%, respectively. Older age, black race, Latino ethnicity, obesity and having a pregnancy complicated by gestational diabetes are all positively associated with developing new-onset LPP. Closer observation may be warranted in these populations.
    American journal of obstetrics and gynecology 11/2013; 210(4). DOI:10.1016/j.ajog.2013.11.004 · 4.70 Impact Factor

  • American Journal of Obstetrics and Gynecology 01/2013; 208(1):S268. DOI:10.1016/j.ajog.2012.10.798 · 4.70 Impact Factor
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    Catherine Bigelow · Alan B. Copperman ·

    Current Frontiers in Cryobiology, 03/2012; , ISBN: 978-953-51-0191-8

  • American Journal of Obstetrics and Gynecology 01/2012; 206(1):S330-S331. DOI:10.1016/j.ajog.2011.10.764 · 4.70 Impact Factor
  • Catherine Bigelow · Erin Moshier · Keith Eddleman · Joanne Stone ·

    American Journal of Obstetrics and Gynecology 01/2012; 206(1):S187. DOI:10.1016/j.ajog.2011.10.419 · 4.70 Impact Factor
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    ABSTRACT: To determine if patients with a low response to controlled ovarian hyperstimulation during IVF benefit from intracytoplasmic sperm injection (ICSI) METHODS: Retrospective analysis of 350 IVF cycles in which four or fewer oocytes were retrieved. Severe male factor cases were excluded from analysis. Conventional insemination (CI) and ICSI were compared, with primary outcome measures of fertilization rate, implantation rate, clinical pregnancy rate per embryo transfer, and pregnancy loss rate. Fertilization rates per oocyte retrieved for CI and ICSI were comparable (51.5% vs. 51.8%). Parallel implantation rates (22% vs. 25%), clinical pregnancy rates (32.8% vs. 33.3%), and loss rates (26.7% vs. 39.5%) were also noted. No difference in cancelled cycles was reported. Our results demonstrate that in the presence of normal semen parameters, low egg number is not an indication to perform ICSI.
    Journal of Assisted Reproduction and Genetics 07/2011; 28(10):911-5. DOI:10.1007/s10815-011-9614-9 · 1.72 Impact Factor
  • Catherine Bigelow · Joanne Stone ·
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    ABSTRACT: The use of bed rest in medicine dates back to Hippocrates, who first recommended bed rest as a restorative measure for pain. With the formalization of prenatal care in the early 1900s, maternal bed rest became a standard of care, especially toward the end of pregnancy. Antepartum bed rest is a common obstetric management tool, with up to 95% of obstetricians utilizing maternal activity restriction in some way in their practice. Bed rest is prescribed for a variety of complications of pregnancy, from threatened abortion and multiple gestations to preeclampsia and preterm labor. Although the use of bed rest is pervasive, there is a paucity of data to support its use. Additionally, many well-documented adverse physical, psychological, familial, societal, and financial effects have been discussed in the literature. There have been no complications of pregnancy for which the literature consistently demonstrates a benefit to antepartum bed rest. Given the well-documented adverse effects of bed rest, disruption of social relationships, and financial implications of this intervention, there is a real need for scientific investigation to establish whether this is an appropriate therapeutic modality. Well-designed randomized, controlled trials of bed rest versus normal activity for various complications of pregnancy are required to lay this debate to rest once and for all.
    Mount Sinai Journal of Medicine A Journal of Translational and Personalized Medicine 03/2011; 78(2):291-302. DOI:10.1002/msj.20243 · 1.62 Impact Factor

Publication Stats

27 Citations
30.13 Total Impact Points


  • 2015
    • Massachusetts General Hospital
      Boston, Massachusetts, United States
  • 2011-2014
    • Icahn School of Medicine at Mount Sinai
      • Department of Obstetrics, Gynecology, and Reproductive Science
      Borough of Manhattan, New York, United States
    • Reproductive Medicine Associates of New York
      New York City, New York, United States
  • 2013
    • Brigham and Women's Hospital
      • Division of General Obstetrics and Gynecology
      Boston, Massachusetts, United States