Association of Food and Housing Insecurity on Outcomes in Pregnant Patients With Substance Use Disorder.

Objectives: Food insecurity (FI) may be associated with worsened neonatal abstinence syndrome severity in infants born to individuals with substance use disorder. This study evaluates FI and housing insecurity (HI) influence on maternal and neonatal outcomes.

Methods: This was a cohort study of patients receiving obstetric care through a multispecialty program in Kentucky from 2015 to 2023.

Weaning buprenorphine in pregnant patients.

Objective: Evaluate maternal and neonatal outcomes after buprenorphine wean compared to patients maintained on buprenorphine throughout pregnancy.

Methods: Prospective cohort study of pregnant patients with opioid use disorder enrolled in a multidisciplinary treatment program between 2015 and 2022. All patients were offered Medications to treat Opioid Use Disorder (MOUD) primarily with buprenorphine.

Buprenorphine Induction Using Microdosing for the Management of Opioid Use Disorder in Pregnancy.

 Conventional buprenorphine inductions require patients to abstain from full agonist opioids until they experience mild-to-moderate opioid withdrawal. We described a successful buprenorphine induction case in a pregnant patient using microdosing, which avoided withdrawal symptoms.  The patient is a 29-year-old G2P1001 at 18 2/7 weeks of gestation, who desired a switch from methadone to buprenorphine to minimize neonatal opioid withdrawal syndrome (NOWS), which complicated her last pregnancy.

Randomized Trials of Retosiban Versus Placebo or Atosiban in Spontaneous Preterm Labor.

Objective: The aim of this study is to assess the efficacy and safety of retosiban in spontaneous preterm labor (sPTL).

Study Design: Two multicenter, randomized, and double-blind trials compared retosiban with placebo and retosiban with atosiban in women with a singleton pregnancy and intact membranes in sPTL at 24 to 33 weeks' gestation. Coprimary endpoints in the placebo-controlled trial were time to delivery (TTD) or treatment failure (whichever occurred first) and neonatal composite morbidity and mortality.

Opioid Addiction in Pregnancy: Does Depression Negatively Impact Adherence With Prenatal Care?

Objective: We aimed to evaluate whether depression in pregnancy in women with opioid dependency negatively impacts adherence with prenatal care.

Methods: This was a retrospective chart analysis of opioid-dependent pregnant women over a 6-year period at 2 large referral and tertiary care centers. The primary outcome was adherence with prenatal care based on the concurrent diagnosis of depression.

Perinatal and Neonatal Outcomes of Triplet Gestations Based on Chorionicity.

 To compare perinatal and neonatal outcomes of dichorionic (DC) and monochorionic (MC) with trichorionic (TC) triplet gestations.  A retrospective cohort study of DC + MC versus TC triplet gestations delivered at a tertiary care hospital from 2009 to 2015. The results include 42 sets of triplets (TC,  = 26; DC + MC,  = 16).

Management of Breast Cancer during Pregnancy: Are We Compliant with Current Guidelines?

 The purpose of this study was to evaluate the management of patients with breast cancer in pregnancy treated at the Advocate Health Care, to determine whether these patients were treated according to guidelines for pregnant patients, which aim to maximize both fetal and maternal outcomes.  A retrospective chart review was performed at the Advocate Lutheran General Hospital, Christ Medical Center, and Illinois Masonic Medical Center from 2002 to 2012 on patients diagnosed with breast cancer during pregnancy using ICD-9 (International Classification of Diseases - 9th version) codes.  Eleven patients between 12 and 37 weeks' gestation matched the search criteria.

Diagnosing Pulmonary Embolism in Pregnancy: Are Biomarkers and Clinical Predictive Models Useful?

Objective The objective of this study was to evaluate whether trimester-specific D-dimer levels or the modified Wells score (MWS) is a useful risk stratification tool to exclude pregnant women at low risk of pulmonary embolism (PE) from diagnostic imaging. Study Design This is a prospective and retrospective cohort study. Pregnant women who underwent diagnostic imaging for suspected PE were prospectively enrolled.

Patterns of fetal growth in an Asian Indian cohort in the USA.

Objective: To determine whether a greater proportion of fetuses in an Asian Indian cohort are classified as small for gestational age than would be expected from a normally distributed population.

Methods: A retrospective analysis of fetal growth pattern and neonatal outcome was conducted among Asian Indian women who were referred to a maternal-fetal medicine center in Park Ridge, IL, USA, for evaluation of fetal growth between January 1, 2012, and December 31, 2013. The primary outcome was an abdominal circumference or estimated weight of lower than the 10th percentile for gestational age according to the Hadlock formula.

Fetal tachycardia treated successfully with maternally administered propylthiouracil.

Background. Fetal tachycardia may result from the transplacental passage of thyroid stimulating immunoglobulins in a patient with hypothyroidism secondary to ablation of Graves' disease. Case.

Ghrelin levels in cord blood from concordant and discordant twin pairs: association with birth weight and postnatal catch-up growth.

Objective: To determine whether cord blood ghrelin levels in discordant and concordant twins predict postnatal catch-up growth.

Methods: After obtaining parental consent, cord blood samples were collected at delivery for total ghrelin analysis. Infant weight, length and head circumference were obtained at birth, 2, 4, and 6 months of age.

A management strategy for fetal immune-mediated atrioventricular block.

Introduction: The purpose of this study is to describe an in utero management strategy for fetuses with immune-mediated 2° or 3° atrioventricular (AV) block.

Methods And Results: The management strategy as applied to 29 fetuses consisted of three parts. First, using fetal echocardiography and obstetrical ultrasound, we assessed fetal heart rate (FHR), heart failure, growth and a modified biophysical profile score (BPS) assessing fetal movement, breathing and tone.

Fetal bladder sagittal length: a simple monitor to assess normal and enlarged fetal bladder size, and forecast clinical outcome.

Purpose: We examined if the parameter of fetal bladder sagittal length (FBSL) could serve as a monitor of normative and enlarged fetal bladder size.

Materials And Methods: There were 76 consecutive cases examined between 1984 and 2000 that included measurement of fetal bladder size as FBSL and postnatal urological followup. Fetal images used to assess normal bladder size were derived from cases in which the bladder was normal on prenatal imaging and postnatal testing.

Single versus weekly courses of antenatal corticosteroids in preterm premature rupture of membranes.

Objective: This study was performed to evaluate the efficacy of weekly courses of antenatal corticosteroids compared with a single course in women with preterm premature rupture of membranes (PROM).

Methods: A planned secondary analysis of women with preterm PROM who participated in a multicenter, randomized trial of weekly courses of antenatal corticosteroids versus single-course therapy was performed. After their first course of standard antenatal steroid therapy, administered between 24 to 32-6/7 weeks of gestation, consenting women were randomly assigned to receive betamethasone versus placebo injections weekly until 34-0/7 weeks of gestation.

Amiodarone therapy for drug-refractory fetal tachycardia.

Background: Fetal tachycardia complicated by ventricular dysfunction and hydrops fetalis carries a significant risk of morbidity and mortality. Transplacental digoxin is effective therapy in a small percentage, but there is no consensus with regard to antiarrhythmic treatment if digoxin fails. This study evaluates the safety, efficacy, and outcome of amiodarone therapy for digoxin-refractory fetal tachycardia with heart failure.

Intermittent airway obstruction and superior vena cava syndrome in a patient with an undiagnosed mediastinal mass after cesarean delivery.

Airway obstruction and cardiovascular collapse may follow the induction of general anesthesia in patients with mediastinal masses. We present a case in which a patient with a diagnosis of an upper gastrointestinal bleed presented for an emergency cesarean delivery. At the conclusion of surgery, the patient had complete airway obstruction during an upper gastrointestinal endoscopy.

Factors associated with success of emergent second-trimester cerclage.

Objective: To assess the factors associated with delivery greater than or equal to 28 weeks' gestation after placement of an emergent cerclage in women with singleton gestations.

Methods: All women who underwent emergent cerclage, defined as any cerclage placed between 16 and 24 6/7 weeks' gestation in response to documented cervical change on physical examination, at Northwestern Memorial Hospital from 1980 to 2000 were identified. Univariable and multivariable analyses were used to determine the factors most associated with achieving at least 28 weeks' gestation.

Antenatal detection of skeletal dysplasias.

Objective: To assess the accuracy of the prenatal diagnosis of skeletal dysplasias.

Methods: All antenatally detected anomalies are coded in our ultrasound database, which is linked with a genetics database that includes outcomes. A final diagnosis is sought on the basis of radiographic studies, molecular testing, or both.