Preoperative Multidisciplinary Team Huddle Improves Communication and Safety for Unscheduled Cesarean Deliveries: A System Redesign Using Improvement Science.

Background: Optimal communication between care teams is a critical component in providing safe, timely, and appropriate patient care. Labor and delivery (L&D) units experience rapidly changing clinical scenarios often requiring escalation in care and unplanned cesarean deliveries (CDs). The University of Cincinnati Medical Center (UCMC) is a 550-bed academic level 4 maternal care center with a 13-bed L&D unit in Cincinnati, OH.

Modulation of lipopolysaccharide-induced chorioamnionitis in fetal sheep by maternal betamethasone.

Objective: We tested the hypothesis that the order of exposure to maternal betamethasone and intra-amniotic (IA) lipopolysaccharide (LPS) will differentially modulate inflammation in the chorioamnion.

Study Design: Time-mated Merino ewes with singleton fetuses received saline alone, IA LPS alone, maternal betamethasone before LPS, or betamethasone after LPS. We assessed inflammatory markers in the chorioamnion and the amniotic fluid.

Neonatal morbidity by week of gestational age for twins compared to singletons: a population-based cohort study.

Objective: Quantify neonatal morbidity by week of gestation for twins compared with singletons.

Study Design: We performed a population-based retrospective cohort study of all Ohio births from 2006 to 2007. Composite neonatal morbidity consisting of Apgar score < 7 at 5 minutes, assisted ventilation > 6 hours, neonatal transport, or seizures was compared between singletons and twins from 34 to 41 weeks.

Modulation of lipopolysaccharide-induced chorioamnionitis by Ureaplasma parvum in sheep.

Objective: Ureaplasma colonization in the setting of polymicrobial flora is common in women with chorioamnionitis, and is a risk factor for preterm delivery and neonatal morbidity. We hypothesized that Ureaplasma colonization of amniotic fluid would modulate chorioamnionitis induced by Escherichia coli lipopolysaccharide (LPS).

Study Design: Sheep received intraamniotic (IA) injections of media (control) or live Ureaplasma either 7 or 70 days before delivery.

Severe sepsis and septic shock in pregnancy: indications for delivery and maternal and perinatal outcomes.

Objective: To report maternal and perinatal outcomes in obstetric patients with severe sepsis and septic shock.

Methods: We performed a retrospective study of obstetric patients admitted to an intensive care unit (ICU) for severe sepsis/septic shock. Maternal clinical characteristics, hemodynamic profiles, laboratory findings, and perinatal outcomes were evaluated.

The influence of hospital type on induction of labor and mode of delivery.

Objective: The purpose of this study was to compare labor induction and cesarean delivery rates at term in community vs university hospitals.

Study Design: A population-based retrospective cohort study of births was performed. Primary outcomes were term gestation at <39 weeks, labor induction, and cesarean delivery.

Late preterm birth.

In the United States, preterm birth rates continue to rise. Many reasons account for this increase, such as demographic changes, infertility treatments, increases in maternal age, more multiple gestations, increasing obesity rates, and maternal comorbid conditions. The American College of Obstetricians and Gynecologists suggests that preterm birth rates have also increased because of a dramatic rise in late preterm births, defined as births between 34 weeks and 36-6/7 weeks of gestation.