Baha M Sibai

• The University of Texas Health Science Center at Houston

OBJECTIVE To investigate the optimal gestational age to deliver pregnant people with chronic hypertension to improve perinatal outcomes. METHODS We conducted a planned secondary analysis of a randomized controlled trial of chronic hypertension treatment to different blood pressure goals. Participants with term, singleton gestations were included....

Objective: The 2 types of maternal skin incisions for in utero spina bifida repair are low transverse (LT) incision perceived to be cosmetic benefit and midline longitudinal (ML) incision, typically associated with a reduction in surgical time and lower blood loss. Our objective was to compare short- and long-term outcomes associated with these 2...

The 2019 Coronavirus (COVID-19) has caused over two-million deaths worldwide, with over 412,000 deaths reported in Unites States. To date, at least 57,786 pregnant women in the US have been infected and 71 have died¹⁻⁴. Although pregnant women are at higher risk for severe COVID-19 related illness, clinical trials for the available vaccines exclude...

Hypertension complicates 7–10% of pregnancies, of which 70% are due to gestational hypertension/preeclampsia and 30% are due to chronic essential hypertension. The pathophysiological abnormalities in preeclampsia include inadequate maternal vascular response to placentation, endothelial dysfunction, abnormal angiogenesis, and exaggerated inflammato...

According to data derived from the National Health and Nutrition Examination Survey, 2015–2016, the prevalence of chronic hypertension among women of childbearing age (18–39 years) is 7.5%. The etiology and severity of chronic hypertension is an important consideration in the management of pregnancy. Chronic hypertension is subdivided into primary...

( Am J Obstet Gynecol . 2020;222:259.e1–259.e11) There is a clear need for quantitative testing methods to determine which patients with signs of preeclampsia may be at heightened risk for adverse pregnancy outcomes. The altered angiogenic factor concentrations including placental growth factor (PlGF) have been found to be associated with preeclamp...

Objective Our primary objective was to determine whether biophysical profiles (BPP) performed on the antepartum unit result in changes in clinical decision making. Study Design A retrospective cohort chart review was performed among women who had a BPP during hospital admission. BPP status was categorized as normal (8/8 points) and abnormal (6/8 or...

The reported incidence of eclampsia is 1.6-10 per 10,000 deliveries in developed countries, where as it is 50-151 per 10,000 deliveries in developing countries. In addition, low resource countries have substantially higher rates of maternal and perinatal mortalities and morbidities. This disparity in incidence and pregnancy outcomes maybe related t...

Qualitative and/or quantitative measurement of urine protein excretion is one of the most common tests performed during pregnancy. For more than 100 years, proteinuria was necessary for the diagnosis of preeclampsia, but recent guidelines recommend that proteinuria is sufficient but not necessary for the diagnosis. Still, in clinical practice, the...

Objectives: To determine the compliance and effectiveness of fortnightly ultrasound surveillance for detection of twin-twin transfusion syndrome (TTTS) in monochorionic diamniotic (MCDA) twin gestations. Methods: This is a retrospective study of ultrasound surveillance of MCDA twins for TTTS. Our surveillance protocol requires fortnightly ultras...

Background Despite expectant management, preeclampsia remote from term usually results in preterm delivery. Antithrombin displays anti-inflammatory and anticoagulant properties and thus may have a therapeutic role treating preterm preeclampsia, a disorder characterized by endothelial dysfunction, inflammation and activation of the coagulation syste...

(Abstracted from Am J Obstet Gynecol 2020;222:259.e1–259.e11) Preeclampsia is a complex and heterogeneous disease, with much of the associated neonatal morbidity related to issues of prematurity incurred from preterm delivery. While there has been robust association between altered concentrations of angiogenic factors, including placental growth fa...

Objective Women with placenta accreta spectrum (PAS) having an unplanned delivery may have worse outcome compared with women with a planned delivery. The primary objective of this study was to compare severe maternal morbidity among women with PAS who had a planned scheduled delivery versus an unplanned delivery. Secondary objective was to compare...

Objective: To evaluate the relationship between maternal body mass index (BMI) at delivery and rates of early-onset and late-onset hypertensive disorders of pregnancy. Methods: We performed a population-based, retrospective cohort study using U.S. Vital Statistics period-linked birth and infant death certificates from 2014 to 2017. Women who del...

Objective: To compare composite maternal and neonatal adverse outcomes among women with at least a bachelor's degree by racial and ethnic groups. Methods: This was a retrospective cohort study using the U.S. vital statistics data sets. We included women with at least a bachelor's degree who delivered a nonanomalous live singleton neonate at 24-4...

Objective Late preterm births (delivery at 34–36 weeks) account for nearly three quarters of the preterm births and among them there is a knowledge gap about an important aspect of infant care: breast versus formula feeding. The aim of this study was to assess factors associated with formula feeding in late preterm neonates. Study Design Secondary...

Objective This study aimed to compare the maternal and neonatal adverse outcomes among singletons delivered at 36 weeks or later with cerclage during index pregnancy versus those without cerclage. Study Design This retrospective cohort study utilized the U.S. vital statistics datasets from 2011 to 2013. Inclusion criteria were women with nonanomalo...

Insufficient O2 supply is frequently associated with fetal growth restriction (FGR), a leading cause of perinatal mortality and morbidity. Although the erythrocyte is the most abundant and only cell type to deliver O2 in our body, its function and regulatory mechanism in FGR remain unknown. Here, we report that genetic ablation of mouse erythrocyte...

Hypertensive disorders are the most common medical complications of pregnancy and a major cause of maternal and perinatal morbidity and death. The detection of elevated blood pressure during pregnancy is one of the cardinal aspects of optimal antenatal care. With the outbreak of novel coronavirus disease 2019 (COVID-19) and the risk for person-to-p...

INTRODUCTION Obesity is a known risk factor for fetal macrosomia (birth weight [BW] greater than or equal to 4,500g), but prior studies examining its effect on sonographic estimated fetal weight (SEFW) have been equivocal. Our objective was to determine the impact of obesity on sonographic detection of macrosomia. METHODS We performed a multicente...

Novel coronavirus disease 2019 (COVID-19) is a respiratory tract infection that was first identified in China. Since its emergence in December 2019, the virus has rapidly spread, transcending geographic barriers. The World Health Organization and the Centers for Disease Control and Prevention have declared COVID-19 as a public health crisis. Data r...

Objective Nulliparous obese women are at increased risk of labor induction and cesarean delivery (CD). We sought to determine whether the combination of a transvaginal Foley balloon plus misoprostol prostaglandin E1 (PGE1) is superior to misoprostol alone in reducing the risk for CD. Study Design We undertook a multicenter, open-label, comparative-...

Objective Our objective was to compare the diagnostic characteristics of sonographic estimated fetal weight (SEFW) done within 7 versus 8-14 days before delivery for detection of fetal macrosomia (birthweight ≥ 4,500 g). Study Design We performed a multicenter, retrospective cohort study of all non-anomalous singletons with SEFW ≥ 4,000 g by Regis...

Aim: The interest in oocyte cryopreservation (OC) for nonmedically indicated reasons is increasing. Knowing women's beliefs and knowledge from various geographic regions could help providers to understand the similarities and differences that could facilitate proper counseling. Materials & methods: Articles about social egg freezing published ov...

Background: Myoinositol (M) and D-chiro-inositol (D) are insulin sensitizer compounds, while Fucoxanthin (F) and hydroxytyrosol (H) are antioxidant substances. We aim to investigate if the combination of these compounds, will improve the vascular responses in pregnant mouse models of hypertension: a genetic model, transgenic heterozygous mice lack...

Objective: To describe the prevalence of hepatitis C virus (HCV) antibody, evaluate current risk factors associated with HCV antibody positivity, and identify novel composite risk factors for identification of groups most likely to demonstrate HCV antibody seropositivity in an obstetric population from 2012 to 2015. Methods: The Eunice Kennedy S...

Objective: To estimate the effect of antenatal treatment of subclinical hypothyroidism on maternal depressive symptoms. Methods: We conducted an ancillary study to a multicenter trial in women with singleton pregnancies diagnosed with subclinical hypothyroidism randomized to antenatal thyroxine therapy or placebo. Treatment was discontinued at t...

Objective: To evaluate whether abnormal plasma placental growth factor (PlGF) level is associated with adverse neonatal and maternal outcomes. Methods: This was a secondary analysis of the Preeclampsia Triage by Rapid Assay Trial (PETRA), a prospective, multicenter, observational study that enrolled women with suspected preeclampsia. Our analysi...

The centuries-old approach to the prevention of eclampsia and its associated maternal morbidity and mortality is based on the recognition of the presence of premonitory signs and symptoms such as hypertension and proteinuria. The spectrum of preceding signs and symptoms came to be known as preeclampsia, which is debatably considered to be an early...

Objective: To determine whether pain score after cesarean delivery is equivalent among women receiving outpatient non-opioid versus opioid analgesics. Study design: In this trial 170 women with cesarean delivery were randomized to outpatient ibuprofen plus acetaminophen (non-opioid, n=85) or ibuprofen plus hydrocodone/acetaminophen (opioid, n=85...

Introduction: To compare neonatal respiratory morbidity among small for gestational age (SGA; birth weight less than 10th percentile for gestational age) versus appropriate for gestational age (AGA; BW at 10–90th percentile) neonates born in the late preterm period. Methods: A secondary analysis of a multicenter randomized trial of antenatal cortic...

Objective We sought to determine if maternal prepregnancy body mass index (BMI) is a risk factor for neonatal respiratory morbidity and to determine if increasing BMI decreased the efficacy of betamethasone (BMZ). Study Design This was a secondary analysis of the Antenatal Late Preterm Steroids trial, double-blind, randomized controlled trial invol...

Purpose Among medical professionals, there appears to be a significant lack of knowledge about oocyte cryopreservation. Medical professionals may be potential candidates for elective oocyte cryopreservation due to the demands and commitments of medical training. There is a paucity of data on this topic among medical professionals. The aim of this s...

Background: There is a robust association between altered angiogenic factor concentrations, which includes placental growth factor and clinically recognized preeclampsia. Alterations in concentrations of angiogenic factors precede the clinical onset of preeclampsia by several weeks. The temporal relationship between the measured angiogenic factors...

Objective To determine whether basal insulin analogs reduce the rate of composite neonatal morbidity compared with neutral protamine Hagedorn (NPH) in women with type 2 diabetes mellitus (T2DM). Study Design This was a retrospective cohort study of women with T2DM and singleton pregnancy at a single tertiary center. Primary outcome was a composite...

(Abstracted from Am J Perinatol 2019;36:422–427) Vasa previa is defined as fetal vessels that run through the fetal membranes, over or within 2-cm distance from the endocervical os and unprotected by the placenta or umbilical cord. Vasa previa is associated with a high fetal or neonatal mortality rate due to risk of fetal exsanguination resulting f...

Objective: To evaluate whether, at 37-39 weeks of gestation, delivery of a neonate with a birth weight that is 90% or greater for gestational age but less than 4,000 g is associated with increased composite maternal and neonatal morbidity. Methods: This retrospective cohort study used U.S. Vital Statistics datasets for the years 2011-2013. Inclu...

INTRODUCTION Fetal growth restriction (FGR) is associated with adverse perinatal outcomes. The aim of our study was to assess NICU admission rates and composite neonatal morbidity (CNM) in pregnancies with persistent FGR, and to evaluate fetal outcomes based on FGR associated with negative growth velocity. METHODS We conducted a retrospective coho...

Objective Little is known about prevalence, risk factors, rate of treatment, or adverse outcomes associated with intrapartum hypertension. Thus, our objective was to describe these findings. Study Design This was a retrospective study of laboring term gestations with no history of hypertensive disorders. Intrapartum blood pressures were reviewed, a...

Introduction: The aim of this study was to assess the success rate of a trial of labor after a previous cesarean section (TOLAC) in the settings of premature rupture of membranes (PROM) and to compare conservative management with spontaneous labor and induction of labor. Methods: This was a retrospective cohort study conducted in a single tertiary...