Middle cerebral artery flow velocity waveforms in normal and small-for-gestational-age fetuses. The secondary objective was to examine the ability of combination models using Elecsys data, 2nd trimester UtA Doppler US measurements, and the serum fetoplacental protein levels used for Down's syndrome screening, to predict PE. They are distinct tests with a start, middle, and end. 2018;45(10):1477-1490. Obstet Gynecol Surv. Official Description The CPT book defines CPT code 78191 as: Platelet survival study. 2006;195(2):478-483. 7. Among 578 patients with complete outcome data, there were 54 cases of PE (9.3 %) and 13 cases of early PE (2.2 %). When you-re reporting 59025, you-d better be sure you-ve got supporting documentation--and the supporting diagnosis to justify this code. However, these investigators stated that further research is needed for re-evaluation and clinical validation of these promising findings of this meta-analysis. Lim S, Li W, Kemper J, Nguyen A, et al. Proper diagnostic reporting to justify the medical necessity and documentation is important to ensure appropriate reimbursement. 90791 90792 . Obstet Gynecol. Mean maternal serum apelin levels were both higher in women who subsequently developed early (8.63.6 versus 5.71.2) or late (9.62.5 versus 8.11.8) pre-eclampsia than those who remained normotensive. Townsend R, Khalil A, Premakumar Y, et al; IPPIC Network. 1997;24(2):79-81. The authors concluded that there is limited evidence that prenatal stress is associated with changes in circulation. The authors concluded that existing evidence does not provide conclusive evidence that the use of routine UAD ultrasound, or combination of umbilical and UAD ultrasound in low-risk or unselected populations benefits either mother or baby. There were no group differences noted for the review's primary outcomes of perinatal death and neonatal morbidity. This Clinical Policy Bulletin contains only a partial, general description of plan or program benefits and does not constitute a contract. 33. 116, November 1992). Ohkuchi A, Minakami H, Shiraishi H, et al. The relationship between ophthalmic Doppler indices and PE could not be a consequence of trophoblast invasion and may be related to maternal hemodynamic adaptation to pregnancy. These investigators searched MEDLINE, EMBASE and Cochrane databases from inception until March 2015 without language restrictions. They had a higher incidence of Ut-A Doppler bilateral notching, higher mean Ut-A Doppler-PI z-scores (p < 0.001) and UA PI z-scores (p = 0.03), but no significant difference in DV-PI z-scores or in the incidence of abnormal qualitative UA and DV patterns. ins.dataset.adClient = pid; Better make sure the patient recorded when she feels the baby moving. The authors concluded that it is possible to predict the discordant twins birth using MCA Doppler velocimetry, but the EFW assessment remains the most accurate method. If no accelerations are found, the physician uses instruments to stimulate the baby or wake the baby up into a moving state. August P, Sibai BM. American College of Gynecology (ACOG)s Practice Bulletin No. A total of 40 pregnant women subsequently developed mild PE, 21 pregnant women subsequently developed severe PE, and 61 cases of normotensive controls were included. Relevant documents were identified using PubMed (US National Library of Medicine, 1983 through 2011) publications, written in English, which describe the peri-partum outcomes of IUGR according to Doppler assessment of umbilical arterial, middle cerebral artery, and ductus venosus. Signore C, Spong C. Overview of antepartum fetal surveillance. Intrapartum fetal assessment. Gynecol Obstet Invest. Repair of first or second degree lacerations.*. These investigatorssearched the Cochrane Pregnancy and Childbirth Group Trials Register (May 2010). } Doppler flow velocity waveform analysis in high risk pregnancies: A randomized controlled trial. Only1 randomized study examined the clinical impact of uterine artery blood flow; in that study, both uterine artery and umbilical artery blood flow were measured. This observation provides the rationale for fetal movement assessment by the mother ("kick counts") as a means of antepartum fetal surveillance. Preeclampsia Screen|T1 is a screening test to measure 3 biochemical markers in the mother's serum associated with PE: alpha-fetoprotein (AFP), pregnancy associated plasma protein-A (PAPPA), and placental growth factor (PIGF). Coding example: 99214, 25. Screening models using multiple markers for early detection of late-onset preeclampsia in low-risk pregnancy. 2010;53(4):869-878. 59000 59070 Antepartum and Fetal Invasive Services for. 2014;44(4):411-418. The monitor records the heart rate and reactivity of the heart rate to fetal heart movement. Services should be billed using Current Procedure Terminology (CPT) codes, Healthcare Common Procedure Coding System (HCPCS) codes and/or revenue codes. Obstet Gynecol. 2nd ed. Further research is needed before screening with uterine artery Doppler can be recommended". There is no available evidence to assess the effect on substantive long-term outcomes such as childhood neurodevelopment and no data to assess maternal outcomes, particularly psychological effects. Some of our partners may process your data as a part of their legitimate business interest without asking for consent. *As per ACOG (American College of Obstetricians and Gynecologists) coding guidelines, reporting of third and fourth degree lacerations should be identified by appending modifier -22 to the global OB code (codes 59400 and 59610) or delivery only code (codes 59409, 59410, 59612, and 59614). Non-Global OB Care, or Partial OB Services Umbilical artery Doppler flow velocimetry has been adapted for use as a technique of fetal surveillance, based on the observation that flow velocity waveforms in the umbilical artery of normally growing fetuses differ from those of growth-restricted fetuses. Abnormal fetal cerebral and umbilical Doppler measurements in fetuses with intrauterine growth restriction predicts the severity of perinatal morbidity. Intrauterine growth restriction. color: red Although Doppler studies of the ductus venous, middle cerebral artery, and other vessels have some prognostic value for IUGR fetuses, currently there is a lack of randomized trials showing benefit. Aetna does not provide health care services and, therefore, cannot guarantee any results or outcomes. 2000;342:9-14. Lancet. A total of 347 women were recruited, of whom 40 developed PE. When billing for the global obstetrical package code, all services must be provided by one obstetrician, one midwife, or the same physician group practice provides all of the patient's routine obstetric care, which includes the antepartum care, delivery, and postpartum care. Clinical significance of absent or reversed end diastolic velocity waveforms in umbilical artery. The ob-gyn checks her and sees that she's dilated 3 cm. 6th Ed. Comparison of the modified biophysical profile to a 'new' biophysical profile incorporating the middle cerebral artery to umbilical artery velocity flow systolic/diastolic ratio. 25. Doppler ultrasonography has not been shown to be of value as a screening test for detecting fetal compromise in the general obstetric population, and its use for this purpose cannot be recommended.". Other Manuals. Fetal movement assessment. Ultrasound Obstet Gynecol. Global OB care should be billed after the delivery date/on delivery date. AHRQ Publication No. ACOG Practice Bulletin No. Ischemia-modified albumin in preterm infants born to mothers with pre-eclampsia. Billing is as follows: Does not require "25" modifier with the insertion code (58300) Am J Obstet Gynecol. The ACOG guidelines on intrauterine growth restriction (2000) state that umbilical artery ultrasounds may be useful in the evaluation of the growth restricted fetus; however, these guidelines indicate no particular role for uterine artery Doppler ultrasound in the evaluation and management of intrauterine growth restriction pregnancies. Smith-Leviton M, Petrikovsky B, Schneider EP. Studied parameters were evaluated using ROC analysis. If you would like to change your settings or withdraw consent at any time, the link to do so is in our privacy policy accessible from our home page.. The modelled performance of screening for PE was also estimated. The difference was significant in early-onset pre-eclamptic women (p<0.05) rather than late-onset pre-eclamptic ones (p>0.05). Inter-twin differences in biometrical parameters delta BPD, delta AC, delta FL, delta EFW and in pulsatility indexes of studied vessels delta UA a delta MCA were expressed. These investigators examined if incorporation of fetal umbilical artery (UA) and ductus venosus (DV) Doppler improves SGA prediction. Bayesian analysis was used to calculate the posterior probability of adverse perinatal outcome following an abnormal or normal UAD assessment. Fretts RC, Elkin EB, Myers ER, Heffner LJ. Policy Am J Obstet Gynecol. In a prospective, clinical study, Musilova and Hodk (2007) evaluated the clinical utility of Doppler velocimetry as a comprehensive test for the prediction of discordant twins. Medicare Reimbursement Rates By Cpt Code 99080 PDF ePub. The authors concluded that sFlt-1 and PlGF were influenced by various factors during the 1st trimester of pregnancy, which can be relevant for correct interpretation. Overall, the test lasts 30-40 minutes, during which the ob-gyn monitors the fetal heart rate using external transducers. -You should make sure you have a specific diagnosis and not just a pregnancy code (V22.x). Preterm infants are classified as SGA or non-SGA according to the Fenton preterm growth chart. Preeclampsia: Clinical features and diagnosis. American College of Obstetricians and Gynecologists Committee on Practice Bulletins -- Obstetrics: Dwight J Rouse. 1993;100:733-741. 1990;97:909-916. Cancer Epidemiol Biomarkers Prev. The authors concluded that this combination of maternal biochemical variables in the 1st trimester could detect a consistent number of late PE. The ob-gyn might repeat this stimulation every five minutes for a maximum of two to three times. Madazli R, Kuseyrioglu B, Uzun H, et al. } 1998;105:422-429. Umbilical artery Doppler velocimetry has not been shown to impact other perinatal outcomes, such as gestational age at birth, birth-weight, Apgar scores, and cesarean birth rates. The procedure described by CPT 59025 takes between 20 and 40 minutes. 2000;183(3):746-751. 17. Did you report combo code 58152 rather than 51840? Ultrasound was used to assess uterine artery Doppler. The delivery only codes should be reported by the same group physician for a single gestation when: https://www.acog.org/practice-management/coding/coding-library, AMA CPT Content Module: Global OB codes Reporting and Use, 2023 RT Welter All Rights Reserved. Youssef et al (2011) examined the performance of screening for late PE by maternal characteristics, uterine artery (UtA) Doppler and a set of biochemical markers in prospectively enrolled women at 11 + 0 to 13 + 6 weeks. Society for Maternal-Fetal Medicine (SMFM), Norton ME, Chauhan SP, Dashe JS. window ["adrum-app-key"] = "EUM-AAB-AUM";window["adrum-start-time"] = new Date().getTime();(window["adrum-config"]||(window["adrum-config"]={})).spa={"spa2" : true}; Aetna considers in-office and in-hospital antepartum fetal surveillance with non-stress tests (NST), contraction stress tests (CST), biophysical profile (BPP), modified BPP, and umbilical artery and middle cerebral Doppler velocimetry medically necessary according to the American College of Obstetricians and Gynecologists (ACOG) Clinical Guideline on Antepartum Fetal Surveillance. var slotId = 'div-gpt-ad-codingahead_com-box-3-0'; Answer: A NST is a discrete test that takes 20-40 minutes to complete and requires a notation of fetal movement as part of the test. Billing for non-global re may occur if: A patient transfers into or out of a physician or group practice. Maternal serum PLGF, PAPPA, -hCG and AFP levels in early second trimester as predictors of preeclampsia. Banta DH, Thacker SB. The overall test performance was summarized using summary receiver operating characteristic (SROC) curve analysis. Aetna considers antepartum fetal surveillance with NST, CST, BPP, modified BPP, and umbilical artery Doppler velocimetry experimental and investigational for all other indications because their effectiveness for indications other than the ones listed above has not been established. The authors concluded that first trimester ADAM12, PAPP-A, and Ut-A Doppler characteristics are not sufficiently predictive of PE. For 4 to 6 visits: Use CPT code 59425 For 7 or more visits: Use CPT code 59426 Once the appropriate code is selected, the below billing guidelines must be followed: When billing an E/M code for a patient seen 1-3 times, each date is reported individually with the corresponding visit date Acta Obstet Gynecol Scand. A recently published meta-analysis of 20 controlled trials of Doppler ultrasonography found, however, that there is "compelling evidence" that knowledge of the Doppler findings improved perinatal outcome in high-risk pregnancies, reducing antenatal admissions, inductions of labor, and cesarean sections for fetal distress, and reducing the odds of perinatal death by 38 %.". Fetal and umbilical Doppler ultrasound in high-risk pregnancies. Chitotriosidase and YKL-40 in normal and pre-eclamptic pregnancies. The following CPT codes are for delivery services only: Vaginal delivery only (with or without episiotomy and/or, Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps), Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery, Based on CPT and ACOG guidelines, the following items are included in the delivery service codes and should not be reported separately, The admission history and physical examination, Management of uncomplicated labor, vaginal delivery (with or without, episiotomy, with or without forceps), or cesarean delivery, external and internal, fetal monitoring provided by the attending physician, Intravenous induction of labor via oxytocin (CPT code 96365-96367), Repair of first or second degree lacerations*, Insertion of cervical dilator (CPT 59200) to be included if performed on the same, If the physician or group physician provide the delivery and postpartum care only, there are CPT codes that encompass both of these services. Official Description The CPT book defines CPT code 44140 as: Colectomy, partial; with anastomosis. The second PSV did not improve the prediction of either preterm or term PE provided by maternal factors alone. Furthermore, an UpToDate review on "Early pregnancy prediction of preeclampsia" (Norwitz, 2018) does not mention the use of ophthalmic artery Doppler as a management option. Diagnosis and management of preeclampsia and eclampsia. Ultrasound Obstet Gynecol. J Postgrad Med. Maternal or fetal echography procedures (CPT codes 76801, 76802, 76805, 76810, 76811, 76812, 76813, 76814, 76815, 76816, 76817, 76820, 76821, 76825, 76826, 76827, Amniocentesis, any method (CPT codes 59000 or 59001), Chorionic villus sampling (CPT code 59015), Fetal contraction stress test (CPT code 59020), External cephalic version (CPT code 59412), Insertion of cervical dilator (CPT code 59200) more than 24 hr before delivery, E&M services which is unrelated to the pregnancy (e.g. Services Included in Global Obstetrical Package. window.ezoSTPixelAdd(slotId, 'adsensetype', 1); American College of Obstetricians and Gynecologists (2000) guidelines on intra-uterine growth retardation (IUGR)reached the following conclusions about the clinical utility of Doppler ultrasound of the umbilical artery: "Although Doppler velocimetry of the umbilical arteries is not useful as a screening technique for IUGR, it has been demonstrated to be useful once IUGR has been diagnosed. 2006;16(2):120-123. For 4 to 6 visits: Use CPT 59425, This code must not be billed by the same, provider in conjunction with one to three office visits, or in conjunction with, For 7 or more visits: Use CPT 59426 Complete antepartum care is limited to, A single claim submission of CPT code 59425 or 59426 for the antepartum care, only, excluding the confirmatory visit that may be reported and separately. container.style.width = '100%'; The false positive rate has been shown to increase following 33 weeks gestation. These recommendations are based upon current evidence and should be used to guide patient management with individualization of care as dictated by the specific clinical circumstance (algorithm 1). Therefore, you would not report a separate NST.Note: For a free PDF of an outpatient fetal monitoring template you can put to use in your practice, e-mail suzannel@eliresearch.com. Use modifier TC when the physician performs the test but does not do the interpretation. Resolution: Billing of modifier 76 (repeat procedure or service by the same physician or other qualified health care professional) or 77 (repeat procedure or service by another physician or other qualified health care professional) should be used to report the performance of multiple diagnostic services on the same day if these were not actually Monitoring of systemic lupus erythematosus pregnancies: A systematic literature review. When the same group physician and/or other healthcare professional provides all components of the OB package, the appropriate CPT code for the Global OB care is reported. This test is rarely used in clinical practice at this time. Loss of reactivity is associated most commonly with the fetal sleep cycle but may result from any cause of central nervous system depression, including fetal acidosis and some medications. Many textbooks and guidelines recommend serial amniocentesis to monitor these pregnancies. 1997;9(5):330-338. 9. For additional quantities, please contact [emailprotected] Policies, Guidelines & Manuals. 2000;343(1):66-67; discussion 67-68. Find out, Learn These In-House Lab Codes And Lasso Reimbursement, Tests with different names don't always mean different codes, See How Your Hysterectomy Responses Measure Up. 1997;59(3):269-270. 2004;104(1):56-64. Also, an UpToDate review on "Doppler ultrasound of the umbilical artery for fetal surveillance" (Maulik, 2017) states that "The principles of managing a high risk pregnancy utilizing UA Doppler velocimetry in conjunction with other fetal surveillance test findings are described below. Helsinki, Finland: Duodecim Medical Publications Ltd.; April 3, 2000. ProviderOne You file all claims through the ProviderOne portal. 498, 03-11-05) 80 - Billing of the Diagnosis and Treatment of Peripheral Neuropathy with Loss of Protective Sensation in People with Diabetes 80.1 General Billing Requirements 80.2 Applicable HCPCS Codes 80.3 Diagnosis Codes 80.4 Payment Fren JF, Heazell AE, Tveit JV, et al. text-decoration: line-through; Discordant fetal growth is common in multiple gestation and usually is defined by a 15 to 25 % reduction in the estimated fetal weight of the smaller fetus when compared with the largest. } 2014 Advanced MIS amp SILS Medicare Reimbursement Coding Guide. Matias and associates (2014) tested the hypothesis that ophthalmic artery Doppler velocimetry is predictive of the development of PE. Models combining markers showed promise, but none had undergone external validation. It does not mention the use of umbilical artery Doppler velocimetry for multiple gestations pregnancies. Smokers had significantly elevated PlGF-values (p < 0.001). 99214 - Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and . What Codes Describe Nuchal Translucency Scans? However, in the United Kingdom, the National Institute for Health and Care Excellence suggests offering PlGF-based testing to help rule out (but not rule in) preeclampsia in women presenting with suspected preeclampsia up to 35 weeks of gestation [citing NICE, 2019]. container.appendChild(ins); Waltham, MA: UpToDate;reviewed November 2015; February 2021. Contractor Name . Am J Obstet Gynecol. Next, the patient's back . Baltimore, MD: Williams & Wilkins; 1996:433-442. van Asselt K, Gudmundsson S, Lindqvist P, et al. 2001;17(6):466-476. When you report 59025 (Fetal non-stress test) for NST procedures, make sure you-re reporting them in the appropriate situations. NICE guideline [NG133]. Next, the patient's back is raised, and the provider attaches two belts to the mother's abdomen. The AUC increased from 0.72 to 0.78 when the PMDV was incorporated into a prediction model based on clinical variables, demonstrating that this marker increased the discriminatory capability of the model. No mothers or neonates died. 1998;77(6):614-619. von See J, Limperger V, Pecks U, Eckmann-Scholz C. Influences on placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) concentration levels at the time of first trimester screening. However, the authors stated that large scale prospective studies areneeded to evaluate the power of this integrated approach in clinical practice. 9. Services Excluded from the Global Obstetrical Package, The following services are excluded from the global OB package (CPT codes 59400, 59510, 59610, and 59618). I know that for a Medicare [], Additional Weakness Will Show Need for Mesh, Question: I need clarification on codes 618.81-618.82. Answer: A NST is a discrete test that takes 20-40 minutes to complete and requires a notation of fetal movement as part of the test. Furthermore, critical appraisal of the very few prospective studies is hampered by limitations in design or insufficient data given by the authors. In: Chesley's hypertensive disorders in pregnancy. display: block; However, the reliability of amniotic fluid bilirubin measurements has been questioned and these tests are of limited value in the second trimester. The consent submitted will only be used for data processing originating from this website. These researchers included5 trials involving 14,185 women. A non-stress test is used to detect accelerations in the fetal heart rate over a 20-40 minute window. Although the slope of the sFlt-1/PlGF ratio was not used in their algorithms, this value may be useful for enhancing predictive accuracy in a future larger scale study. The authors concluded that ophthalmic artery Doppler is a simple, accurate and objective technique with a standalone predictive value for the development of early-onset PE equivalent to that of uterine artery Doppler evaluation. A -reactive- NST will show the fetal heart rate accelerate from the baseline 15 beats per minute for a minimum of 15 seconds at least twice during a 10-minute window. There was a negative correlation between sFlt-1 and maternal BMI (rS = -0.225, p = 0.005). American College of Obstetricians and Gynecologists (ACOG), Committee on Practice Bulletins -- Obstetrics. The ob-gyn did not use the external transducer to examine the fetus- condition but to monitor the patient's contractions. 2018;51(6):731-737. These high sensitivities and acceptable false-positive rates support the potential clinical applicability of the method to reduce the reliance on, and even replace, cordocentesis and amniocentesis with its attendant complications in Rh maternal alloimmunization pregnancies. Ananth CV, Smulian JC, Vintzileos AM. These parameters were tested for their ability to predict subsequent delivery of a SGA infant. The ob-gyn admits her to the hospital and places the external transducer on the woman's abdomen, giving her medication to halt the labor. ins.className = 'adsbygoogle ezasloaded'; There was a positive correlation between sFlt-1 and PAPP-A MoM (rS = 0.681, p < 0.001), and PlGF and PAPP-A MoM (rS = 0.465, p < 0.001), respectively. The effect of introduction of umbilical Doppler recordings to obstetric practice. Areview of the evidenceforuterine artery Doppler studies prepared for the Society for Maternal Fetal Medicine (Scicioneand Hayes,2009)found that the predictive value of Doppler testing in a low-risk population of women appears to be low, and currently there are no available interventions to prevent adverse outcomes based on an abnormal result. In a systematic review, Kuc et al (2011) examined the literature on the predictive potential of first-trimester serum markers and of UAD velocity waveform assessment (uterine artery [Ut-A] Doppler). #closethis { Fetal umbilical artery flow velocity waveforms and placental resistance: Pathological correlation. First-trimester prediction of small-for-gestational age neonates incorporating fetal Doppler parameters and maternal characteristics. Serum YKL-40, a new prognostic biomarker in cancer patients? Summary estimates; the pooled sensitivity, specificity, and the diagnostic odds ratio (DOR) of IMA for the diagnosis of PE were computed using random-effects models. Ultrasound Obstet Gynecol. Last Review Utility of antepartum umbilical artery Doppler velocimetry in intrauterine growth restriction. Use the codes below for billing antepartum-only, postpartum-only, delivery-only or delivery and postpartum only services. 2015;9:13-20. Obstet Gynecol Surv. While both sites followed a very similar protocol with regards to timing of delivery, the decision was at the discretion of the individual clinicians, and not standardized to the study. A nurse will listen to and record the baby's heartbeat while the baby is resting and while the baby . Mayer-Pickel et al (2018) stated that an imbalance of angiogenic placental factors such as endoglin, sFlt-1 and PlGF has been implicated in the pathophysiology of PE. To read the full article, sign in and subscribe to the AMA CPT Assistant. Umbilical artery Doppler assessment is most useful in pregnancies complicated by fetal growth restriction and/or preeclampsia. .fixedHeaderWrap { Examples of such high-risk conditions include bleeding, chronic or pregnancy-induced hypertension, collagen vascular disease (including anti-phospholipid syndrome), fetal growth restriction, gestational diabetes, impaired renal function, maternal heart disease (New York Heart Association Class III or IV), oligohydramnios, significant isoimmunization, steroid-dependent or poorly controlled asthma (not an all-inclusive list). Bahado-Singh RO, Oz AU, Hsu C, et al. However, because of its limited predictive ability as a stand-alone test, UAD should be used in combination with other tests to guide clinical decisions. Am J Obstet Gynecol. Based on the readings from the transducer, the labor stops. Cochrane DatabaseSyst Rev. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites. The postpartum care only should be reported by the same physician that provides the patient with services of postpartum care only. 2012;206(4):300-308. These researchers carried out a retrospective study including 161 patients during the 1st trimester screening between 11+0 and 13+6 weeks of gestation. Are these added codes we should use in [], 2 Babies, 2 Ob-Gyns Doesn't Have to Spell Trouble, Question: We-ve been having trouble with insurance reimbursement for the assistance of a second physician [], 7 Surefire Strategies for Pap Smear Coding Success, Copyright 2023. Although UAD is more accurate in the second trimester,these investigatorsfound encouraging results for first-trimester screening when it was combined with other markers. Almstrom H, Axelsson O, Cnattingius S, et al. 2019 53(4):465-472. The corresponding positive and negative likelihood ratios (PLRs and NLRs) were 16.5 and 0.6 for perinatal mortality and 2.82 and 0.65 for composite adverse perinatal outcome, respectively. The important factor here is that the ob-gyn did not admit the patient for delivery. Role of Kleihauer test in Rhesus negative pregnancy. Br J Obstet Gynaecol. Both the normal pregnant and pre-eclamptic subjects were subdivided into 2 groups. These researchers stated that prospective, well-designed studies of predictive markers, preferably randomized intervention studies, and combined through individual-patient data meta-analysis are needed to develop and validate new prediction models to facilitate the prediction of PE and minimize further research waste in this field. Waltham, MA: UpToDate;reviewed September 2014; November 2015.

Oak Woods And Prairies Weathering, Highest Crime Suburbs Christchurch, Mandurah Upcoming Events, Articles OTHER