Chiropractic Care for the Pregnant Body.

Chiropractic care is a commonly used treatment modality for musculoskeletal pain in pregnancy. Low back pain, pelvic pain, and other neuromuscular complaints are prevalent in pregnancy and contribute to significant maternal discomfort in many women. Nonpharmacologic therapies to relieve pain are increasingly important during pregnancy because of the opioid epidemic.

Effect of Prophylactic Negative Pressure Wound Therapy vs Standard Wound Dressing on Surgical-Site Infection in Obese Women After Cesarean Delivery: A Randomized Clinical Trial.

Importance: Obesity increases the risk of both cesarean delivery and surgical-site infection. Despite widespread use, it is unclear whether prophylactic negative pressure wound therapy reduces surgical-site infection after cesarean delivery in obese women.

Objective: To evaluate whether prophylactic negative pressure wound therapy, initiated immediately after cesarean delivery, lowers the risk of surgical-site infections compared with standard wound dressing in obese women.

A stillbirth calculator: Development and internal validation of a clinical prediction model to quantify stillbirth risk.

Objective: To generate a clinical prediction tool for stillbirth that combines maternal risk factors to provide an evidence based approach for the identification of women who will benefit most from antenatal testing for stillbirth prevention.

Design: Retrospective cohort study.

Setting: Midwestern United States quaternary referral center.

Obesity and cell-free DNA "no calls": is there an optimal gestational age at time of sampling?

Background: Cell-free DNA screen failures or "no calls" occur in 1-12% of samples and are frustrating for both clinician and patient. The rate of "no calls" has been shown to have an inverse relationship with gestational age. Recent studies have shown an increased risk for "no calls" among obese women.

Use of a simple clinical tool for airway assessment to predict adverse pregnancy outcomes.

Objective: Obstructive sleep apnea (OSA) is a risk factor for adverse perinatal outcomes. We aimed to test the hypothesis that maternal Mallampati class (MC), as a marker for OSA, is associated with adverse perinatal outcomes.

Study Design: We performed a retrospective secondary analysis of a prospective cohort of term births (≥ 37 weeks).

Balancing the risks of stillbirth and neonatal death in the early preterm small-for-gestational-age fetus.

Objective: Timing of delivery for the early preterm small-for-gestational-age (SGA) fetus remains unknown. Our aim was to estimate the risk of stillbirth in the early preterm SGA fetus compared with the risk of neonatal death.

Study Design: We performed a retrospective cohort study of singleton pregnancies that underwent second-trimester anatomy ultrasound (excluding fetal anomalies, aneuploidy, and pregnancies with incomplete neonatal follow-up data).

Diagnosis of spina bifida on ultrasound: always termination?

Open spina bifida is a non-lethal fetal anomaly. Significant advances in the prevention, diagnosis and treatment of open spina bifida have been made over the past 75 years. The most significant strategy for the prevention of open spina bifida has been with folic acid supplementation; however, further investigation into the complicated role that genetics and the environment play in metabolism are coming to light.

Discussion: 'Sleep-disordered breathing and adverse pregnancy outcomes' by Pamidi et al.

In the roundtable that follows, clinicians discuss a study published in this issue of the Journal in light of its methodology, relevance to practice, and implications for future research.

Discussion: 'Time from consent to cesarean delivery,' by Salmeen et al.

In the roundtable that follows, clinicians discuss a study published in this issue of the Journal in light of its methodology, relevance to practice, and implications for future research. Article discussed: Salmeen K, Brincat C. Time from consent to cesarean delivery during labor.

Risk of stillbirth after 37 weeks in pregnancies complicated by small-for-gestational-age fetuses.

Objective: The evidence for delivering small-for-gestational-age (SGA) fetuses at 37 weeks remains conflicting. We examined the risk of stillbirth per week of gestation beyond 37 weeks for pregnancies complicated by SGA.

Study Design: Singleton pregnancies undergoing routine second trimester ultrasound from 1990-2009 were examined retrospectively.