2016
Evidence for participation of neutrophil gelatinase‐associated lipocalin/matrix metalloproteinase‐9 (NGAL•MMP‐9) complex in the inflammatory response to infection in pregnancies complicated by preterm birth
Rood KM, Buhimschi IA, Rodewald Millen K, Bahtiyar MO, Thung S, Summerfield T, Zhao G, Ackerman W, Shellhaas C, Samuels P, Buhimschi CS. Evidence for participation of neutrophil gelatinase‐associated lipocalin/matrix metalloproteinase‐9 (NGAL•MMP‐9) complex in the inflammatory response to infection in pregnancies complicated by preterm birth. American Journal Of Reproductive Immunology 2016, 76: 108-117. PMID: 27251223, PMCID: PMC4942349, DOI: 10.1111/aji.12523.Peer-Reviewed Original ResearchConceptsIntra-amniotic infection/inflammationNeutrophil gelatinase-associated lipocalinMatrix metalloproteinase-9Preterm birthNGAL mRNA expressionGelatinase-associated lipocalinNormal pregnancy outcomeAmniotic fluid levelsInfection/inflammationPlacental villous trophoblastNGAL levelsPregnancy outcomesInflammatory conditionsInflammatory responseMetalloproteinase-9Villous trophoblastFluid levelsInnate immunityCollagenolytic effectMRNA expressionGelatinolytic activityPregnancyHost-microbe interactionsQRT-PCRAmniochorion
2015
Compartmentalization of acute phase reactants Interleukin-6, C-Reactive Protein and Procalcitonin as biomarkers of intra-amniotic infection and chorioamnionitis
Dulay AT, Buhimschi IA, Zhao G, Bahtiyar MO, Thung SF, Cackovic M, Buhimschi CS. Compartmentalization of acute phase reactants Interleukin-6, C-Reactive Protein and Procalcitonin as biomarkers of intra-amniotic infection and chorioamnionitis. Cytokine 2015, 76: 236-243. PMID: 25957466, PMCID: PMC4824401, DOI: 10.1016/j.cyto.2015.04.014.Peer-Reviewed Original ResearchMeSH KeywordsAdultAmniocentesisAmniotic FluidAsymptomatic InfectionsBiomarkersCalcitoninCalcitonin Gene-Related PeptideChorioamnionitisC-Reactive ProteinFemaleFetal BloodFetal Membranes, Premature RuptureHumansInfant, NewbornInterleukin-6Obstetric Labor, PrematurePlacentaPregnancyPregnancy Complications, InfectiousPremature BirthProtein PrecursorsSystemic Inflammatory Response SyndromeConceptsIntra-amniotic infectionC-reactive proteinSubclinical intra-amniotic infectionIL-6Blood IL-6 levelsBlood IL-6Maternal blood levelsSystemic inflammatory responseIL-6 levelsNon-invasive biomarkersSubgroup of casesChorioamnionitis groupHistological chorioamnionitisInflammatory markersPreterm laborCRP levelsInflammatory biomarkersMaternal serumPlacental pathologyAcute phasePregnant womenBlood levelsSubclinical phaseInterleukin-6Cord blood
2014
A comprehensive obstetric patient safety program reduces liability claims and payments
Pettker CM, Thung SF, Lipkind HS, Illuzzi JL, Buhimschi CS, Raab CA, Copel JA, Lockwood CJ, Funai EF. A comprehensive obstetric patient safety program reduces liability claims and payments. American Journal Of Obstetrics And Gynecology 2014, 211: 319-325. PMID: 24925798, DOI: 10.1016/j.ajog.2014.04.038.Peer-Reviewed Original Research
2012
Mode of Delivery and Neonatal Outcomes in Preterm, Small-for-Gestational-Age Newborns
Werner EF, Savitz DA, Janevic TM, Ehsanipoor RM, Thung SF, Funai EF, Lipkind HS. Mode of Delivery and Neonatal Outcomes in Preterm, Small-for-Gestational-Age Newborns. Obstetrics And Gynecology 2012, 120: 560-564. PMID: 22914464, PMCID: PMC3739844, DOI: 10.1097/aog.0b013e318265b16c.Peer-Reviewed Original ResearchConceptsGestational age newbornsRespiratory distress syndromeNeonatal outcomesCesarean deliveryMethod of deliveryDistress syndromeGestational ageVaginal delivery groupIntrauterine growth restrictionMeeting study criteriaWeeks of gestationHospital discharge dataMode of deliveryLarge diverse cohortSGA newbornsVertex neonatesNeonatal morbidityPrepregnancy weightIntraventricular hemorrhageVaginal deliveryDelivery groupStudy criteriaBirth weightMaternal ageGrowth restrictionPregestational Diabetes With Extreme Insulin Resistance
Zuckerwise LC, Werner EF, Pettker CM, McMahon-Brown EK, Thung SF, Han CS. Pregestational Diabetes With Extreme Insulin Resistance. Obstetrics And Gynecology 2012, 120: 439-442. PMID: 22825259, DOI: 10.1097/aog.0b013e31824fd27d.Peer-Reviewed Original ResearchConceptsSevere insulin resistanceInsulin resistanceGlycemic controlInsulin requirementsDiabetic patientsPregestational diabetes mellitusTreatment of patientsExtreme insulin resistancePregestational diabetesDiabetes mellitusRegular insulinPregnant womenPatientsHigh dosesInsulinPregnancyEffective alternativeWomenMellitusNonadherenceDiabetesDosesControlEvaluating the cost‐effectiveness of prenatal surgery for myelomeningocele: a decision analysis
Werner E, Han C, Burd I, Lipkind H, Copel J, Bahtiyar M, Thung S. Evaluating the cost‐effectiveness of prenatal surgery for myelomeningocele: a decision analysis. Ultrasound In Obstetrics And Gynecology 2012, 40: 158-164. PMID: 22511529, DOI: 10.1002/uog.11176.Peer-Reviewed Original ResearchConceptsPrenatal myelomeningocele repairQuality-adjusted life yearsMyelomeningocele repairPostnatal repairMyelomeningocele patientsPrenatal surgeryAdditional casesLong-term medical careFuture pregnancy complicationsIncremental cost-effectiveness ratioPostnatal myelomeningocele repairCost-effectiveness ratioDecision analysis modelingUterine ruptureNeurologic deficitsPregnancy complicationsSingleton gestationsSurgery resultsLife yearsMedical carePatientsCost-effective strategyNormal karyotypeNeonatesSurgeryAntenatal lamivudine to reduce perinatal hepatitis B transmission: a cost-effectiveness analysis
Nayeri UA, Werner EF, Han CS, Pettker CM, Funai EF, Thung SF. Antenatal lamivudine to reduce perinatal hepatitis B transmission: a cost-effectiveness analysis. American Journal Of Obstetrics And Gynecology 2012, 207: 231.e1-231.e7. PMID: 22939730, DOI: 10.1016/j.ajog.2012.06.001.Peer-Reviewed Original ResearchConceptsChronic hepatitis BHepatitis BLamivudine administrationPerinatal transmissionThird trimesterPregnant womenPerinatal hepatitis B transmissionAdministration of lamivudineMaternal hepatitis BHepatitis B transmissionCost-effectiveness analysisDecision analysis modelExpectant managementLiver transplantPregnant patientsHepatocellular carcinomaB transmissionLamivudineCost-effective strategyAdministrationTrimesterPregnancyWomenPatientsCarcinomaScreening for Gestational Diabetes Mellitus: Are the Criteria Proposed by the International Association of the Diabetes and Pregnancy Study Groups Cost-Effective?
Werner EF, Pettker CM, Zuckerwise L, Reel M, Funai EF, Henderson J, Thung SF. Screening for Gestational Diabetes Mellitus: Are the Criteria Proposed by the International Association of the Diabetes and Pregnancy Study Groups Cost-Effective? Diabetes Care 2012, 35: 529-535. PMID: 22266735, PMCID: PMC3322683, DOI: 10.2337/dc11-1643.Peer-Reviewed Original ResearchConceptsGestational diabetes mellitusIncremental cost-effectiveness ratioPregnancy Study GroupsIADPSG recommendationsPostdelivery careDiabetes mellitusStudy groupRisk of preeclampsiaPrimary outcome measureFuture diabetes riskCurrent screening practicesCost-effectiveness ratioCurrent standardDecision analysis modelGDM womenIADPSG criteriaFuture diabetesBirth injuryGlucose screeningShoulder dystociaDiabetes riskScreening practicesOutcome measuresDiabetesPrenatal monitoring
2011
Proteomics Mapping of Cord Blood Identifies Haptoglobin “Switch-On” Pattern as Biomarker of Early-Onset Neonatal Sepsis in Preterm Newborns
Buhimschi CS, Bhandari V, Dulay AT, Nayeri UA, Abdel-Razeq SS, Pettker CM, Thung S, Zhao G, Han YW, Bizzarro M, Buhimschi IA. Proteomics Mapping of Cord Blood Identifies Haptoglobin “Switch-On” Pattern as Biomarker of Early-Onset Neonatal Sepsis in Preterm Newborns. PLOS ONE 2011, 6: e26111. PMID: 22028810, PMCID: PMC3189953, DOI: 10.1371/journal.pone.0026111.Peer-Reviewed Original ResearchConceptsEarly-onset neonatal sepsisCord bloodNeonatal outcomesNeonatal sepsisPreterm newbornsAdverse short-term neonatal outcomesShort-term neonatal outcomesSelection of newbornsIntra-amniotic infectionIntra-ventricular hemorrhageLatent class analysisEONS diagnosisAntenatal exposurePreterm birthProspective cohortPremature newbornsAdverse outcomesInterleukin-6Odds ratioProtein immunoreactivityTargeted treatmentTwo-dimensional differential gel electrophoresisElevated haptoglobinNewbornsImportant causeUltrasonographic Evaluation of Myometrial Thickness and Prediction of a Successful External Cephalic Version
Buhimschi CS, Buhimschi IA, Wehrum MJ, Molaskey-Jones S, Sfakianaki AK, Pettker CM, Thung S, Campbell KH, Dulay AT, Funai EF, Bahtiyar MO. Ultrasonographic Evaluation of Myometrial Thickness and Prediction of a Successful External Cephalic Version. Obstetrics And Gynecology 2011, 118: 913-920. PMID: 21934456, DOI: 10.1097/aog.0b013e31822e63fe.Peer-Reviewed Original ResearchConceptsAmniotic fluid indexExternal cephalic versionFundal myometrial thicknessSuccessful external cephalic versionMyometrial thicknessCephalic versionFluid indexHigher amniotic fluid indexAbdominal ultrasonographic scansFetal spine positionConsecutive pregnant womenAbsolute risk reductionBody mass indexExternal cephalic version successStrong independent predictorAbdominal wall thicknessMultivariate regression analysisPlacental thicknessBreech presentationIndependent predictorsFetal weightMass indexPregnant womenUltrasonographic evaluationBirth weightUniversal cervical‐length screening to prevent preterm birth: a cost‐effectiveness analysis
Werner EF, Han CS, Pettker CM, Buhimschi CS, Copel JA, Funai EF, Thung SF. Universal cervical‐length screening to prevent preterm birth: a cost‐effectiveness analysis. Ultrasound In Obstetrics And Gynecology 2011, 38: 32-37. PMID: 21157771, DOI: 10.1002/uog.8911.Peer-Reviewed Original ResearchConceptsCervical length screeningPreterm birthVaginal progesteroneCervical lengthWeeks' gestationLong-term neurologic deficitsUniversal cervical length screeningLow-risk singleton pregnanciesTransvaginal cervical length measurementCost-effective strategyIncremental cost-effectiveness ratioTransvaginal cervical lengthVaginal progesterone supplementationCervical length measurementLow-risk pregnanciesMain outcome measuresCost-effectiveness ratioCost-effectiveness analysisDecision analysis modelNeonatal outcomesNeurologic deficitsSingleton pregnanciesProgesterone supplementationRoutine careNeonatal deathIL-6 Trans-Signaling System in Intra-Amniotic Inflammation, Preterm Birth, and Preterm Premature Rupture of the Membranes
Lee SY, Buhimschi IA, Dulay AT, Ali UA, Zhao G, Abdel-Razeq SS, Bahtiyar MO, Thung SF, Funai EF, Buhimschi CS. IL-6 Trans-Signaling System in Intra-Amniotic Inflammation, Preterm Birth, and Preterm Premature Rupture of the Membranes. The Journal Of Immunology 2011, 186: 3226-3236. PMID: 21282511, PMCID: PMC3800180, DOI: 10.4049/jimmunol.1003587.Peer-Reviewed Original ResearchMeSH KeywordsAdultAmniocentesisAmniotic FluidCytokine Receptor gp130FemaleFetal Membranes, Premature RuptureHumansInfant, NewbornInfant, PrematureInflammation MediatorsInterleukin-6Matrix Metalloproteinase 9Matrix Metalloproteinase InhibitorsPregnancyPregnancy ComplicationsPremature BirthReceptors, Interleukin-6Signal TransductionYoung AdultConceptsIntra-amniotic inflammationSIL-6RIL-6RPremature ruptureIL-6Classic IL-6 signalingAF IL-6RT-PCRPreterm premature ruptureIL-6 signalingMatrix metalloprotease-9Real-time RT-PCRActivation of cellsPhysiologic constituentPreterm laborPreterm birthIL-6 TransGestational ageThird trimesterInflammatory cellsSecond trimesterNormal gestationMetalloprotease-9IL-6 bindsFetal membranesAccreta complicating complete placenta previa is characterized by reduced systemic levels of vascular endothelial growth factor and by epithelial-to-mesenchymal transition of the invasive trophoblast
Wehrum MJ, Buhimschi IA, Salafia C, Thung S, Bahtiyar MO, Werner EF, Campbell KH, Laky C, Sfakianaki AK, Zhao G, Funai EF, Buhimschi CS. Accreta complicating complete placenta previa is characterized by reduced systemic levels of vascular endothelial growth factor and by epithelial-to-mesenchymal transition of the invasive trophoblast. American Journal Of Obstetrics And Gynecology 2011, 204: 411.e1-411.e11. PMID: 21316642, PMCID: PMC3136625, DOI: 10.1016/j.ajog.2010.12.027.Peer-Reviewed Original ResearchConceptsVascular endothelial growth factorComplete placenta previaPlacenta previaEndothelial growth factorCytokeratin 7Growth factorExtravillous trophoblastsSystemic vascular endothelial growth factorMesenchymal transitionFree vascular endothelial growth factorInterstitial extravillous trophoblastsMesenchymal transition featuresPlacental growth factorAngiogenic factor profilesExpression of vimentinInvasive extravillous trophoblastsUncomplicated pregnanciesMyometrial invasionPregnant womenPreviaInvasive trophoblastFactor profileHistological specimensInvasive placentationSerum samples
2010
Interpretation of Amniotic Fluid White Blood Cell Count in “Bloody Tap” Amniocenteses in Women With Symptoms of Preterm Labor
Abdel-Razeq SS, Buhimschi IA, Bahtiyar MO, Rosenberg VA, Dulay AT, Han CS, Werner EF, Thung S, Buhimschi CS. Interpretation of Amniotic Fluid White Blood Cell Count in “Bloody Tap” Amniocenteses in Women With Symptoms of Preterm Labor. Obstetrics And Gynecology 2010, 116: 344-354. PMID: 20664395, PMCID: PMC4142228, DOI: 10.1097/aog.0b013e3181e8fec6.Peer-Reviewed Original ResearchConceptsWhite blood cellsAmniotic fluid white blood cellBlood cell countWBC countAmniotic fluidBloody tapAmniotic fluid white blood cell countCell countAmniotic fluid WBC countRBC/White blood cell countPositive amniotic fluid cultureMaternal WBC countRed blood cell countCells/Number of neutrophilsAbsence of inflammationSetting of inflammationAmniotic fluid culturePositive likelihood ratioAmniotic fluid samplesIntraamniotic inflammationPreterm laborConsecutive womenFluid cultureAcceleration/ejection time ratio in the fetal pulmonary artery predicts fetal lung maturity
Azpurua H, Norwitz ER, Campbell KH, Funai EF, Pettker CM, Kleine M, Bahtiyar MO, Malkus H, Copel JA, Thung SF. Acceleration/ejection time ratio in the fetal pulmonary artery predicts fetal lung maturity. American Journal Of Obstetrics And Gynecology 2010, 203: 40.e1-40.e8. PMID: 20417479, DOI: 10.1016/j.ajog.2010.01.075.Peer-Reviewed Original ResearchConceptsAcceleration time/ejection time ratioEjection time ratioFetal lung maturityLecithin/sphingomyelin ratioFetal pulmonary arteryLung maturitySphingomyelin ratioPulmonary arteryAcceleration/ejection time ratioPulmonary artery blood flowSystolic/diastolic ratioYale-New Haven HospitalAmniotic fluid biomarkersAmniotic fluid lecithin/sphingomyelin ratioArtery blood flowFlow velocity waveformsFlow velocity parametersNew noninvasive techniqueSingleton pregnanciesDiastolic ratioPulsatility indexUltrasound evaluationFluid biomarkersPotential confoundersStudy criteria
2009
Impact of a comprehensive patient safety strategy on obstetric adverse events
Pettker CM, Thung SF, Norwitz ER, Buhimschi CS, Raab CA, Copel JA, Kuczynski E, Lockwood CJ, Funai EF. Impact of a comprehensive patient safety strategy on obstetric adverse events. American Journal Of Obstetrics And Gynecology 2009, 200: 492.e1-492.e8. PMID: 19249729, DOI: 10.1016/j.ajog.2009.01.022.Peer-Reviewed Original ResearchConceptsObstetric adverse eventsAdverse Outcome IndexAdverse eventsOutcome indexPatient safety strategiesPatient safety committeePatient safety interventionsNumber of deliveriesAdverse outcomesObstetric servicesTotal deliveriesNurse positionsPatient safetySafety interventionsSafety CommitteeInterventionOutcomesSignificant improvementExpert reviewSafety climateComprehensive strategyDeliverySafety strategiesProtocol standardization
2008
Multidimensional Proteomics Analysis of Amniotic Fluid to Provide Insight into the Mechanisms of Idiopathic Preterm Birth
Buhimschi IA, Zhao G, Rosenberg VA, Abdel-Razeq S, Thung S, Buhimschi CS. Multidimensional Proteomics Analysis of Amniotic Fluid to Provide Insight into the Mechanisms of Idiopathic Preterm Birth. PLOS ONE 2008, 3: e2049. PMID: 18431506, PMCID: PMC2315798, DOI: 10.1371/journal.pone.0002049.Peer-Reviewed Original ResearchMeSH KeywordsAdultAmniotic FluidBiomarkersDown-RegulationElectrophoresis, Gel, Two-DimensionalFemaleHemorrhageHumansInflammationPlacentaPregnancyPregnancy ProteinsPremature BirthProteomeProteomicsRNA, MessengerSoftwareSpectrometry, Mass, Matrix-Assisted Laser Desorption-IonizationTreatment OutcomeUmbilical CordUp-RegulationConceptsPreterm birthAmniotic fluidIdiopathic preterm birthIntra-amniotic inflammationMost preterm birthsSubgroup of patientsAbsence of inflammationDistinct pathogenetic mechanismsFuture drug developmentProteomic fingerprintExpectant managementNovel pathogenetic pathwaysPreterm laborPremature ruptureClinical resultsPathogenetic mechanismsPathogenetic pathwaysConsecutive sampleTherapeutical interventionsInflammationSELDI peaksBirthBleedingProtein metabolismDrug developmentNucleated red blood cells are a direct response to mediators of inflammation in newborns with early-onset neonatal sepsis
Dulay AT, Buhimschi IA, Zhao G, Luo G, Abdel-Razeq S, Cackovic M, Rosenberg VA, Pettker CM, Thung SF, Bahtiyar MO, Bhandari V, Buhimschi CS. Nucleated red blood cells are a direct response to mediators of inflammation in newborns with early-onset neonatal sepsis. American Journal Of Obstetrics And Gynecology 2008, 198: 426.e1-426.e9. PMID: 18395034, PMCID: PMC4023236, DOI: 10.1016/j.ajog.2008.01.040.Peer-Reviewed Original ResearchConceptsEarly-onset neonatal sepsisNucleated red blood cellsInflammation-associated preterm birthNRBC countAcid-base statusIntraamniotic inflammationHistological chorioamnionitisNeonatal sepsisRed blood cellsPreterm birthGestational ageCord blood IL-6 levelsBlood IL-6 levelsFetal acid-base statusBlood cellsAbsolute NRBC countsIL-6 levelsEarly neonatal periodIntrauterine growth restrictionHours of birthEarlier gestational ageMediators of inflammationMinutes of deliveryAbsence of hypoxiaPreterm singletonsUsing Proteomic Analysis of the Human Amniotic Fluid to Identify Histologic Chorioamnionitis
Buhimschi IA, Zambrano E, Pettker CM, Bahtiyar MO, Paidas M, Rosenberg VA, Thung S, Salafia CM, Buhimschi CS. Using Proteomic Analysis of the Human Amniotic Fluid to Identify Histologic Chorioamnionitis. Obstetrics And Gynecology 2008, 111: 403-412. PMID: 18238979, DOI: 10.1097/aog.0b013e31816102aa.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAmniocentesisAmniotic FluidBiomarkersBlack or African AmericanChorioamnionitisFemaleHumansInflammationPregnancyPregnancy Complications, InfectiousPregnancy OutcomePrevalenceProteomeProteomicsReproducibility of ResultsSensitivity and SpecificitySeverity of Illness IndexSpectrometry, Mass, Matrix-Assisted Laser Desorption-IonizationWhite PeopleConceptsHistologic chorioamnionitisAmniotic fluidIntra-amniotic inflammationGrade of inflammationAbsence of biomarkersHuman amniotic fluidSurface-enhanced laser desorption ionization timeAfrican American womenPreterm laborSingleton pregnanciesDelivery intervalPlacental pathologyGestational agePremature ruptureSevere inflammationEarly recognitionChorioamnionitisChorionic plateInflammationTherapeutic interventionsProteomic biomarkersCalgranulin CBiomarkersProteomic analysisScoresMultidimensional System Biology: Genetic Markers and Proteomic Biomarkers of Adverse Pregnancy Outcome in Preterm Birth
Buhimschi C, Rosenberg V, Dulay A, Thung S, Sfakianaki A, Bahtiyar M, Buhimschi I. Multidimensional System Biology: Genetic Markers and Proteomic Biomarkers of Adverse Pregnancy Outcome in Preterm Birth. American Journal Of Perinatology 2008, 25: 175-187. PMID: 18425720, DOI: 10.1055/s-2008-1061497.Peer-Reviewed Original ResearchConceptsPreterm birthSignificant public health problemMost preterm birthsAdverse pregnancy outcomesWeeks of gestationPublic health problemVariety of interventionsNeonatal outcomesPregnancy outcomesDecidual hemorrhagePremature infantsPremature birthLikely multifactorialPathophysiological pathwaysHealth problemsPathophysiological conditionsProteomic biomarkersOxidative stressBirthExcessive stretchingOutcomesHemorrhageGestationInfantsEtiology