Pregnancy and Birth

Hypertensive disorders of pregnancy are among the leading contributors to maternal mortality worldwide. This review describes hypertension-related maternal mortality in the United States and key strategies to improve outcomes.

Cutting-edge medical advances and innovative technologies have made headlines and continue to flourish in the new millennium. However, these medical achievements stand in stark contrast to the paradoxical increase in US maternal mortality, which is among the highest of all developed nations.

Women with endometriosis at first singleton pregnancy are about 1.5 times more likely to have a preterm birth (PTB), according to a meta-analysis.

Data from more than 1.9 million subjects shows that women with endometriosis have a statistically higher risk of obstetric complications including preterm birth (PTB) than those without the condition.

Longitudinal data from a prospective cohort study indicate that being born early term may negatively affect a child’s cardiorespiratory fitness. Plus: Is there a difference in PTB rate between branded and compounded 17P? Also, a review analyzes whether or not there are any benefits to placentophagy.

A systematic review and meta-analysis suggests that in pregnancies conceived via assisted reproduction, risk of adverse perinatal outcomes may be higher with donated than with autologous oocytes. Plus: Do post-cesarean antibiotics reduce infections in obese women? Also: Researchers believe they have identified the genes associated with preterm delivery.

The plaintiff alleged that the infant’s injuries were caused by traumatic damage during delivery; specifically, from the vacuum extractor. The plaintiff’s argument was that when the vacuum extractor pulled on the infant’s head it caused damage, evidenced by the intraventricular bleed.

This article reviews complications that may occur following perineal trauma, techniques to help prevent these complications, and best practices for management using case vignettes.

Physiologic changes during pregnancy affect the body’s hormonal milieu as well as a woman’s sexual desires, responses, and practices. In this review, we discuss knowledge gaps, the physiology of the female sexual response during pregnancy, types of sexual activity during pregnancy, and existing literature on anatomic and physiologic changes by trimester and postpartum.

PTB can be readily separated into spontaneous and indicated PTB, and, thus, treatment or prevention for one might be counterproductive for the other.

A new study looks at whether midpelvic operative deliveries have greater trauma than other delivery forms. Plus: A look at the long-term effects of using bisphosphonates. Also, is lithium use in early pregnancy as dangerous as previously thought?

The latest on testing guidelines for Zika from the CDC. Plus: Are corticosteroids effective when administered only hours before delivery? Also, a look at the prevalence of hepatitis C among pregnancy women in the United States.

A round-up of research on obesity in pregnancy from the ACOG 2017 meeting in San Diego, California.

Case rests on physician’s ability to inspire confidence in choices made in the OR.

A debate at ACOG 2017 looks at whether cervical insufficiency should be abandoned as a diagnosis. Plus: A study presented at ACOG 2017 examines whether human papillomavirus is linked to preterm birth?

Expert commentary on Practice Bulletin No. 161: External Cephalic Version

Dr Greenberg reports his thoughts on the Sureglide device and preventing lacerations during cesarean, Überlube and helping women with vaginal dryness and dyspareunia, and TruClear ULTRA Mini tissue removal device for mechanical morcellation.

Too many ob/gyns believe that doing something is better than doing nothing, says this reader.

EPF diagnosis can cause harm, so 100% specificity is the goal.

A new study looks at whether who begin menarche early in life are more likely to develop GDM. Plus: USPSTF issues their final recommendations on pelvic exams. Also, a look at the efficacy of vaginal progesterone in preventing preterm birth in twin pregnancy.

A study looks at the impact of a preterm birth on the mother's future risk of cardiovascular disease. Plus: Do shift work and physical labor negatively impact a woman's fertility? Also, are women who get a false-positive mammogram more likely to delay their future screenings?

Readers write in about their thoughts on the annual labor force survey, the conundrum presented by cesarean delivery and defensive medicine, more information on treating women who have been the victim of sexual assault, and what is adding to the stress of the job.

Can adopting quality measures decrease the cesarean rate? Plus: The Government Accountability Office issues a report on power morcellators and the FDA's system of evaluation. Also, does the volume of one type of heart fat indicate the risk of heart disease?

Susan C Olmstead and Yalda Afshar, MD, PhD, discuss birth plans and whether there is a place for them.

The plaintiff asserted that during the diagnostic laparoscopy, Dr A and Dr B should have detected the ectopic pregnancy in the right fallopian tube. Her attorneys claimed that based upon the plaintiff’s abdominal pain, vaginal bleeding, and β- hCG levels, and absent evidence of intrauterine pregnancy on ultrasound, the defendants should have presumed ectopic pregnancy and adequately evaluated the fallopian tube before discharging the patient, thus avoiding rupture.

Identifying and Counseling Patients at Risk for Recurrent Preterm Birth. Improving Women’s Understanding of Recurrent Preterm Birth. Society for Maternal-Fetal Medicine (SMFM) Clinical Guideline on Reducing the Risk of Preterm Birth and Potential Treatment in Certain At-Risk Women. Strategies for implementing the SMFM clinical guideline for reducing the risk of preterm birth in women with a history of recurrent preterm birth.

Research looks at the science showing associations between microcephaly and Zika virus. Plus: Can cervical pessaries help prevent preterm birth? Also, a study examines whether inadvertent HPV vaccination during pregnancy leads to adverse outcomes for mother and baby.