History of prematurity and the patient's age did not increase a patient's risk of failure. Nonresponders to high-flow nasal cannula therapy were on the onset, more hypercarbic, were less tachypnic prior to the start of high-flow nasal cannula, and had no change in their respiratory rate after the initiation of high-flow nasal cannula therapy. Nonresponders had higher pediatric risk of mortality scores in the first 24 hrs.
The principle of an integrated optic component providing four optical signals in quadrature is presented. Such an interferometric element has been fabricated by ion -exchange in glass. The effect of various parameters on the quadrature condition have been studied: length of the mixing section, temperature, polarisation. Losses have been characterised. A possible use of this device is illustrated.
Childbirth represents a significant portion of health care expenditures in the United States. 1 A great deal of these costs is because of obstetric procedures, with the average cost of vaginal delivery increasing over time. 2 In the present climate of pandemic, new protocols are emerging that allow for medical care in an outpatient environment. It is imperative that health care systems consider options for outpatient obstetric procedures. The ARRIVE trial demonstrated a lower risk of
INTRODUCTION:
More than 20% of pregnant women in the U.S. undergo induction. Due to an unfavorable cervix, many of the women presenting for induction experience longer labor times, increased rates of cesarean section and increased healthcare costs. The purpose of the study was to examine the difference in cesarean section rates, maternal and neonatal morbidity and costs for outpatient vs inpatient Foley induction.
METHODS:
We conducted a retrospective case control study using data from the Kaiser Permanente electronic medical record for the Orange County Service area. Cases were identified using a log of all patients receiving Foley bulb placement. Controls were identified through the electronic health record using Current Procedural Terminology codes and International Classification of Diseases 9th Revision codes for induction of labor from 2013-2015. Cases and controls were matched by advanced maternal age status, parity and race. Patients were excluded if they had a modified bishop score >6 or nonvertex presentation or <37 weeks gestation.
RESULTS:
Between 9/2013 and 12/2015, 283 cases were identified and matched 1:1 to controls. There was no difference between cases and controls for rate of cesarean (P>0.89) or for maternal (P>0.37) or neonatal morbidity (P<0.5). Cases were more likely to have an infant with a higher birth weight (P<0.01), have a shorter length of hospitalization for labor and delivery (P<0.01) and lower costs of hospitalization (P<0.01). Cost was quantified, with average 300 dollars per patient savings for outpatient induction.
CONCLUSION:
Outpatient Foley bulb placement is a safe, cost effective alternative for women undergoing induction of labor.
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