Author Interviews, OBGYNE, Pediatrics / 04.02.2020

MedicalResearch.com Interview with: [caption id="attachment_53073" align="alignleft" width="179"]Andrea M. Tilstra Doctoral Candidate, Department of Sociology Population Program, Institute of Behavioral Science University of Colorado Boulder Andrea Tilstra[/caption] Andrea M. Tilstra Doctoral Candidate, Department of Sociology Population Program, Institute of Behavioral Science University of Colorado Boulder MedicalResearch.com: What is the background for this study? Response: Average U.S. birth weight declined across the 1990s and 2000s, and this has puzzled most researchers. We investigate this and find that the increases in cesarean deliveries and induction of labor between 1990 and 2013 resulted in a shift in the gestational age distribution of U.S. births. We find that births are less likely to occur at gestational weeks 40+ and much more likely to occur between weeks 37-39. Additionally, results from our simulations show that if U.S. rates of cesarean deliveries and labor induction had not increased over time, then average birth weight would have increased.  
Author Interviews, OBGYNE, Opiods, Pain Research / 28.01.2020

MedicalResearch.com Interview with: [caption id="attachment_52986" align="alignleft" width="140"]Dave Stack Chief Executive Officer and Chairman Pacira BioSciences David Stack[/caption] Dave Stack Chief Executive Officer and Chairman Pacira BioSciences  MedicalResearch.com: What is the background for this study? Response: Cesarean sections (C-sections) are one of the most common surgeries in the United States, and research shows many women experience moderate to severe pain after this procedure. When postsurgical pain is inadequately managed for new mothers, it can interfere with recovery, maternal-infant bonding and may even lead to postpartum depression. Additionally, prescribing data reveals that postsurgical opioid consumption poses a great risk to women. We recently completed a Phase 4 study of EXPAREL in C-section patients, and results revealed adding EXPAREL to bupivacaine transversus abdominis plane (TAP) blocks for C-section delivery provided significant reductions in opioids and pain scores. Results of that study provided the basis for the design of this next-generation study, which was created to be completely opioid-free in the EXPAREL arm. The study was a Phase 4 multicenter, active-controlled study conducted in 18 clinical sites in the United States, with 169 enrolled patients undergoing elective C-section. The enrolled C-section patients were randomized to receive either 150 mcg morphine spinal anesthesia plus a standard of care postoperative pain regimen, 50 mcg morphine spinal anesthesia plus EXPAREL TAP field block, or opioid-free spinal anesthesia plus EXPAREL TAP block. Patients in the EXPAREL arms received a protocol-defined non-opioid postsurgical pain management regimen including ketorolac, acetaminophen, and ibuprofen. 
Author Interviews, Blood Clots, CHEST, OBGYNE, Surgical Research, Thromboembolism / 27.09.2016

MedicalResearch.com Interview with: Marc Blondon, MD Division of Angiology and Hemostasis, Department of Specialties of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Office of Research and Development, Seattle, WA MedicalResearch.com: What is the background for this study? What are the main findings? Response: Venous thromboembolism, a condition including deep vein thrombosis (blood clots) and pulmonary embolism, is more common in older than younger patients. However, pregnancy and particularly the postpartum period are times at greater risk of blood clots in women. It is important to understand the risk and the risk factors for thrombosis in the postpartum period to guide the use of preventive measures such as heparin, an anticoagulant treatment, or leg compression devices. Our study summarizes the evidence on the link between C-sections and blood clots from the past 35 years. Our meta-analysis demonstrates that:
  • C-section carries a 4-fold increased risk of blood clots in the postpartum period, compared with vaginal deliveries ;
  • that this risk is most prominent but not restricted to emergency C-section ;
  • and that women who undergo elective C-section are also at higher risk than women who have a vaginal delivery.
  • Importantly, we estimated an absolute risk of blood clots after a C-section of 2-4 per 1000 pregnancies: on average, 3 out of 1000 women after C-section will develop a blood clot.
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, Medicare, OBGYNE / 04.01.2016

[caption id="attachment_20403" align="alignleft" width="120"]Dr. Sarah Elizabeth Little, MD Obstetrics/Gynecology Department of Obstetrics and Gynecology Brigham and Women's Hospital Dr. Little[/caption] MedicalResearch.com Interview with: Dr. Sarah Elizabeth Little, MD Obstetrics/Gynecology Department of Obstetrics and Gynecology Brigham and Women's Hospital Medical Research: What is the background for this study? What are the main findings? Dr. Little: This study investigates the variation in cesarean delivery rates across hospital services areas (a geographic unit designed by the Dartmouth Atlas to represent local markets for primarily hospital-based medical services). We looked at whether variation in cesarean delivery rates was related to broader variation in overall medical spending and utilization in that area, which we measured with Medicare spending and hospital use at the end-of-life. We found that an area’s cesarean delivery rate was correlated with these other measures; in other words, the hospital services areas that are doing the most cesarean deliveries are the same ones that are spending more and doing more to non-obstetric patients as well.