Richard Burwick

Richard Burwick
Cedars-Sinai Medical Center ·  Department of Obstetrics and Gynecology

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63
Publications
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Publications

Publications (63)
Article
Background: Use of intraperitoneal local anesthetic to treat intraoperative pain during cesarean delivery has not been described previously. The aim of this study was to determine if intraperitoneal chloroprocaine may be useful as an adjunct to neuraxial block in reducing the proportion of patients with severe intraoperative pain that requires con...
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Thrombotic microangiopathy (TMA) disorders are characterized by microangiopathic hemolytic anemia, thrombocytopenia and end-organ injury. In pregnancy and postpartum, TMA is most commonly encountered with HELLP (hemolysis, elevated liver enzymes, low platelet count syndrome) or preeclampsia with severe features, but rarely TMA is due to thrombotic...
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Purpose of review: Preeclampsia affects 3-4% of pregnancies with few treatment options to reduce maternal and fetal harm. Recent evidence that targeting the complement system may be an effective therapeutic strategy in prevention or treatment of preeclampsia will be reviewed. Recent findings: Studies in humans confirm the safety and efficacy of...
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Objective: To assess the incidence and severity of preeclampsia in pregnancies complicated by fetal hydrops. Methods: We performed a retrospective cohort study of singleton gestations from 2005–2008 in California. The primary predictor was fetal hydrops and the primary outcome was preeclampsia. Selected adverse maternal and neonatal events were ass...
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Objective Traditionally, physiological variation in fetal weight is believed to emerge during the latter half of pregnancy. Although recent evidence suggests that crown-rump length (CRL) and nuchal translucency (NT) measured at 11–14 weeks correlate with abnormal fetal growth, findings have been limited by dating accuracy in spontaneous gestations....
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INTRODUCTION: A 2013 report from the American College of Obstetricians and Gynecologists (the College) task force removed greater than 5g proteinuria in a 24-hour urine collection from the severe symptoms list for preeclampsia. We sought to determine the perinatal outcomes following implementation of this guideline. METHODS: A decision analytic mod...
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Background: Pregnant women with chronic myeloid leukemia (CML) can be treated effectively with the tyrosine-kinase inhibitor imatinib, but data regarding fetal and neonatal exposure and safety are limited. Case: We present a patient with newly diagnosed CML in early pregnancy. Leukapheresis and interferon-α were initiated in the second trimester...
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Objective: To determine whether adverse outcomes were more common in late preterm pregnancies complicated by preeclampsia and growth restriction compared to those affected by preeclampsia alone. Methods: This was a retrospective cohort study of 8,927 singleton pregnancies with preeclampsia. Pregnancies with small for gestational age (SGA) neonates...
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Preeclampsia continues to contribute to major maternal and neonatal morbidity and mortality worldwide. In this article, we review the pathophysiological mechanisms, screening strategies, and novel therapeutic options for preeclampsia.
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Eclampsia is a rare yet dangerous complication of the hypertensive disorders of pregnancy. The objective was to elucidate the predictors of eclampsia in a large cohort of pregnant women with gestational hypertension or preeclampsia. This was a retrospective cohort study of 143 093 pregnancies with preeclampsia or gestational hypertension in Califor...
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To characterize maternal and feto-placental phenotypes of severe preeclampsia that trigger early-onset delivery. A retrospective cohort review of pregnant women receiving care from 2000 to 2010. Subjects with early-onset severe preeclampsia delivering between 20 and 32 weeks were identified excluding multiple gestations or major anomalies. We defin...
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To evaluate the ongoing risk of intrauterine fetal demise (IUFD) in non-anomalous pregnancies affected by polyhydramnios. We analyzed a retrospective cohort of all singleton, non-anomalous births in California between 2005-2008 as recorded in a statewide birth certificate registry. We included all births between 24+0 weeks and 41+6 weeks gestationa...
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Severe preeclampsia has been independently linked to complement dysregulation and angiogenic imbalance; however, the relationship between complement and angiogenic factors in human pregnancy is unclear. Utilizing existing biomarkers, our study sought to better understand this relationship in active disease. We performed a case-control study, enroll...
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Kidney injury with proteinuria is a characteristic feature of preeclampsia, yet the nature of injury in specific regions of the nephron is incompletely understood. Our study aimed to use existing urinary biomarkers to describe the pattern of kidney injury and proteinuria in pregnancies affected by severe preeclampsia. We performed a case-control st...
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The complement cascade is activated in normal pregnancy, and excessive complement activation propagates the systemic inflammatory response in severe preeclampsia. Consequently, biomarkers of complement dysregulation may be useful for prediction or treatment of disease. Because renal damage with proteinuria is a characteristic pathological feature o...
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Background Free fetal DNA (ffDNA) testing for aneuploidy has recently started being offered to all women in our institution who are high risk for trisomy 21 (aged 35 or over at estimated date of delivery). We therefore examined the uptake rate of ffDNA for aneuploidy screening in women of advanced maternal age who had been seen by a genetic counsel...
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Severe preeclampsia with hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome is a leading cause of maternal and neonatal morbidity and mortality worldwide. Occurrence at an extremely premature gestational age is most challenging as there are dichotomous imperatives: delivery as definitive therapy for maternal health vs. prolongatio...
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Abstract Objective: To determine the effectiveness of a novel algorithm based on fetal fibronectin (FFN) for management of preterm labor (PTL) Methods: A randomized trial was performed on patients who presented with symptoms of preterm labor at 24 - 34 weeks. Patients were randomized to algorithms with cervical exams only vs. cervical exams plus FF...
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To estimate current trends in continuing medical education among obstetrician-gynecologists in relation to the Maintenance of Certification program. A validated questionnaire was mailed to 1,030 randomly selected physicians of the American College of Obstetricians and Gynecologists in the United States, Puerto Rico, and Canada. Participants were as...
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To determine whether cervical length (CL) measured by the Cervilenz™ measuring device is an effective screening tool for the prediction of preterm delivery (PTD) compared to fetal fibronectin (fFN). We evaluated fFN and CL among women who enrolled into a randomized control trial (RCT) comparing management algorithms for threatened preterm labor bet...
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Cervical length (CL) examinations may identify patients in preterm labor or those who may benefit from prophylactic therapy. We sought to compare the accuracy of clinician digital CL examinations with objective measurements using the Cervilenz device in women presenting with symptoms of preterm labor. Forty-two patients with singleton gestation fro...
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Previous studies have examined the role of APOE variation in multiple sclerosis (MS), but have lacked the statistical power to detect modest genetic influences on risk and disease severity. The meta- and pooled analyses presented here utilize the largest collection, to date, of MS cases, controls, and families genotyped for the APOE epsilon polymor...

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