Ann M Thomas

Objectives: Regular users of the emergency department (ED) include both patients who could be better served in lower-acuity settings and those with high-severity conditions. ED use decreased during the COVID-19 pandemic, but patterns among regular ED users are unknown. To determine the impact of the COVID-19 pandemic on this population, we examine...

This cohort study describes changes in myocardial infarction and stroke hospitalizations as well as congestive heart failure, angina, and transient ischemic attack incidents months before and after March 2020 among insured people in New England.

PurposeTo compare clinical outcomes following transfer of euploid blastocysts of varying quality biopsied on day 5 versus day 6.Methods Retrospective cohort study to evaluate embryo transfer outcomes for women undergoing autologous cryopreserved next generation sequencing euploid single embryo transfer from 10/2015 to 2/2022 at an academic IVF prog...

Purpose Supraphysiologic serum estradiol levels may negatively impact the likelihood of conception and live birth following IVF. The purpose of this study is to determine if there is an association between serum estradiol level on the day of progesterone start and clinical outcomes following programmed frozen blastocyst transfer cycles utilizing or...

Background Many young women with breast cancer undergo fertility preservation (FP) before cancer treatment. This study examined the impact of FP on breast cancer outcomes. Methods The authors performed a retrospective cohort study of 272 women aged 20 to 45 years with newly diagnosed stage 0 to III breast cancer who underwent an FP consultation be...

Background A number of studies have looked at dual triggers with hCG and GnRH agonist (GnRHa) in varying doses, but the question remains: what is the optimal dose of hCG to minimize ovarian hyperstimulation syndrome (OHSS) and still offer adequate pregnancy rates? The purpose of this study was to compare pregnancy and OHSS rates following dual trig...

Background More than 67% of all embryos transferred in the United States involve frozen-thawed embryos. Progesterone supplementation is necessary in medicated cycles to luteinize the endometrium and prepare it for implantation, but little data is available to show if this is beneficial in true natural cycles. We evaluated the use of luteal phase pr...

Background A controversial and unresolved question in reproductive medicine is the utility of preimplantation genetic testing for aneuploidy (PGT-A) as an adjunct to in vitro fertilization (IVF). Infertility is prevalent, but its treatment is notoriously expensive and typically not covered by insurance. Therefore, cost-effectiveness is critical to...

Purpose To test whether an electronic whiteboard in the IVF laboratory increases the likelihood that critical evaluation procedures are performed within optimum pre-set time ranges. Methods A retrospective cohort study of oocyte retrievals in our IVF clinic between 06/01/2012 and 05/31/2018 was included. The electronic whiteboard was introduced on...

Background: The optimal route of progesterone administration for luteal support in cryopreserved embryo transfer (CET) has been the subject of much debate. While most published research has pertained to day 3 transfers, recent data on blastocyst CET has suggested that intramuscular progesterone (IMP) is superior to twice daily vaginal Endometrin s...

Background: More than 67% of all embryos transferred in the United States involve frozen-thawed embryos. Progesterone supplementation is necessary in medicated cycles in order to luteinize the endometrium and prepare it for implantation, but little data is available if this is necessary in true natural cycles. We evaluated the use of progesterone l...

Background: More than 67% of all embryos transferred in the United States involve frozen-thawed embryos. Progesterone supplementation is necessary in medicated cycles in order to luteinize the endometrium and prepare it for implantation, but little data is available if this is necessary in true natural cycles. We evaluated the use of luteal phase p...

Background: More than 67% of all embryos transferred in the United States involve frozen-thawed embryos. Progesterone supplementation is necessary in medicated cycles to luteinize the endometrium and prepare it for implantation, but little data is available to show if this is beneficial in true natural cycles. We evaluated the use of luteal phase p...

Purpose With advances in cancer therapy, reproductive-aged women can look forward to a life post-malignancy. Fortunately, fertility preservation (FP) may provide relief from potential infertility caused by cancer or associated caustic treatments. Outcomes of FP in pre-treatment reproductive-aged women with gliomas have not been previously character...

Purpose To assess the importance of each blastocyst morphological criteria with pregnancy and perinatal outcomes. Methods This single-center retrospective cohort study included blastocyst single embryo transfers (SET) performed between 1/2012–2/2018. Poisson regression was used to evaluate pregnancy outcomes following fresh and cryopreserved embry...

Purpose We developed a postpartum transition clinic to better support women after hypertensive pregnancy. Description Our program goals were (1) early postpartum hypertension medical management, (2) patient and provider education around CVD risk, (3) transition to primary care provider (PCP) and (4) a sustainable clinical model reimbursed by privat...

Purpose To determine whether the presence of endometriosis in infertile women without prior ovarian surgery influences markers of ovarian reserve, AMH and FSH. Methods A retrospective cohort study included three groups of women who presented for IVF treatment at our tertiary care center from 04/27/2015 to 05/31/2017: women with endometriosis and p...

Background: It is critical to evaluate the combined impact of age and body mass index (BMI) on the cumulative likelihood of live birth following in vitro fertilization (IVF), as achieving a lower BMI prior to infertility treatment is often recommended for women with overweight and obesity. It is important to consider whether achieving a particular...

Objective To assess public attitudes toward placing age limits on men and women seeking fertility treatment. Design Cross-sectional web-based survey. Setting Not applicable. Patient(s) A nationally representative sample of 1,427 adults in the United States. Intervention(s) Not applicable. Main Outcome Measure(s) Support for placing age limits...

( Acta Obstet Gynecol Scand . 2017;96(8):1021–1028) There is a lack of agreement among organizations regarding the recommended timing of delivery for patients with placenta previa-accreta. The American Congress of Obstetricians and Gynecologists and The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) suggest...

Objective: To assess the effect of infant size as a marker of placental function on the association between preeclampsia and the ratio of soluble fms-like tyrosine kinase 1 (sFlt-1) to placental growth factor (PlGF). Study design: The angiogenic factors sFlt-1 and PlGF were measured prospectively at 26 weeks gestation in 2322 women. Pregnancies...

We thank Dr. Matsubara and colleagues(1) for commenting on our study, "Patient selection for later delivery timing with suspected previa-accreta."(2) We particularly appreciate the emphasis on individualized patient care, and that access (or lack thereof) to a tertiary center with experience in managing abnormally invasive placenta (AIP) is of para...

Introduction: We identified patients with previa and suspected accreta who are at lowest risk of unscheduled delivery or major morbidity with planned delivery beyond 34 weeks gestation. Material and methods: This was a retrospective cohort study of patients who had reached 34.0 weeks gestational age with a suspected previa-accreta. We evaluated...

Background Previous studies have shown an association between total excessive gestational weight gain and hypertension in pregnancy. However, this may be a reflection of excessive water retention associated with the pathophysiology of hypertensive disorders of pregnancy. Early excessive weight gain, prior to the third trimester, results in greater...

Objective: To assess whether changes in maternal angiogenic factors throughout pregnancy predict the development of preeclampsia. Study design: Placental growth factor (PlGF) and soluble fms-like tyrosine kinase 1 receptor (sFlt-1) were measured in 2355 women at 10, 18, 26 and 35 weeks gestation. Receiver operator characteristic analysis was use...

Given the importance of the fetal adrenal gland in producing hormones critical to labor, we sought to evaluate whether sonographic 3-dimensional measurements of the adrenal gland are a useful screening tool for spontaneous preterm birth (SPTB). We prospectively screened 128 non-anomalous singletons from 24-36 weeks' gestation with volumetric measur...

To assess health care providers' knowledge regarding pregnancy outcome as a risk factor for cardiovascular disease and evaluate the variables associated with their responses to questions about routine surveillance for cardiovascular disease. A voluntary, anonymous survey of internal medicine and obstetric and gynecologic health care providers at an...

Fetal growth restriction is a strong risk factor for stillbirth. We aimed to compare the performance of three fetal growth curves: customized, ultrasound (Hadlock), and population, in identifying abnormally grown fetuses at risk of stillbirth. We performed a case-control study of singleton stillbirths (2000-2010) at one center. Four liveborn contro...

Objective: We aimed to study whether prenatal vitamin (PNV) use protects against low 25-hydroxyvitamin D (25[OH]D) levels in all women and particularly in obese and black women who are both at risk of vitamin D deficiency and poor pregnancy outcomes. Study design: We studied 1019 women enrolled in a prospective study at Brigham and Women's Hospi...

Women with antepartum preeclampsia are at higher risk of developing cardiovascular disease. We sought to assess if the introduction of a specialized postpartum clinic decreases the rate of readmission and triage visits and increases the rate of primary care provider follow-up for women who had antepartum preeclampsia. This is a retrospective compar...

(Am J Obstet Gynecol. 2012;207(4):309.e1–6)

Use of prenatal ultrasonography (US) has risen concomitantly with the increase in cesarean delivery (CD) rates. Sonographic overestimation of fetal macrosomia may be associated with a lower threshold for CD for labor arrest. If obtaining the US estimated fetal weight (US-EFW) near term increases the risk of CD, this could be a modifiable risk facto...

The purpose of this study was to investigate whether knowledge of ultrasound-obtained estimated fetal weight (US-EFW) is a risk factor for cesarean delivery (CD). Retrospective cohort from a single center in 2009-2010 of singleton, term live births. CD rates were compared for women with and without US-EFW within 1 month of delivery and adjusted for...

Background: National initiatives offering non-nucleoside reverse transcriptase inhibitor (NNRTI)-based combination anti retroviral therapy (cART) have expanded in sub-Saharan Africa. The Tshepo study is the first clinical trial evaluating the long-term efficacy and tolerability of efavirenz versus nevirapine-based cART among adults in Botswana. Met...

National initiatives offering non-nucleoside reverse transcriptase inhibitor (NNRTI)-based combination antiretroviral therapy (cART) have expanded in sub-Saharan Africa. The Tshepo study is the first clinical trial evaluating the long-term efficacy and tolerability of efavirenz versus nevirapine-based cART among adults in Botswana. A 3-year randomi...

Numerous national antiretroviral (ARV) treatment initiatives offering protease inhibitor-sparing combination antiretroviral therapy (cART) have recently commenced in southern Africa, the first of which began in Botswana in January 2002. Evaluation of the efficacy and tolerability of various protease inhibitor-sparing cART regimens requires intensiv...

Objective Adequate nutrition is needed for optimal immune response. We examined the relationship of energy intake to disease progression in asymptomatic HIV+ adults in Botswana. Methods After obtaining informed consent from 806 HIV+ adults, data on demographic and nutritional status were collected. Blood was drawn for CD4 cell count and viral load...

The ability of nucleoside reverse transcriptase inhibitors (NRTIs) to inhibit human mitochondrial polymerase-gamma results in impaired synthesis of mitochondrial enzymes that generate adenosine triphosphate (ATP) by oxidative phosphorylation. This has been associated with several long-term mitochondrial toxicities, which include lactic acidosis and...

HIV-1C has become the dominant HIV-1 subtype in the global AIDS epidemic. Historically, the evolution of drug-resistant mutations was characterized primarily among antiretroviral (ARV)-treated HIV-1B infections. Whereas the non-B viruses are susceptible to the currently used ARVs, some differences between HIV-1 subtypes in response to ARV regimens...

Millions of HIV-infected women in developing countries are in need of safe and highly effective antiretroviral therapy. Pregnancy rates are usually high in developing countries, and efavirenz (EFV) use in women of childbearing age is of concern because of its potential teratogenicity. As part of a prospective study comparing 6 initial highly active...

Metabolic syndrome increases the risk of cardiovascular outcomes and type II diabetes. Most of the metabolic abnormalities defining metabolic syndrome are observed in HIV. To determine the incidence and risk factors for metabolic syndrome in HIV-infected adults in the Nutrition for Healthy Living (NFHL) study (2000-2003) and prevalence relative to...