A comparison of obstetric maneuvers for the acute management of shoulder dystocia.

Objective: To assess the efficacy of obstetric maneuvers for resolving shoulder dystocia and the effect that these maneuvers have on neonatal injury when shoulder dystocia occurs.

Methods: Using an electronic database encompassing 206,969 deliveries, we identified all women with a vertex fetus beyond 34 0/7 weeks of gestation who incurred a shoulder dystocia during the process of delivery. Women whose fetuses had a congenital anomaly and women with an antepartum stillbirth were excluded.

Contemporary patterns of spontaneous labor with normal neonatal outcomes.

Objective: To use contemporary labor data to examine the labor patterns in a large, modern obstetric population in the United States.

Methods: Data were from the Consortium on Safe Labor, a multicenter retrospective study that abstracted detailed labor and delivery information from electronic medical records in 19 hospitals across the United States. A total of 62,415 parturients were selected who had a singleton term gestation, spontaneous onset of labor, vertex presentation, vaginal delivery, and a normal perinatal outcome.

Contemporary cesarean delivery practice in the United States.

Objective: To describe contemporary cesarean delivery practice in the United States.

Study Design: Consortium on Safe Labor collected detailed labor and delivery information from 228,668 electronic medical records from 19 hospitals across the United States, 2002-2008.

Results: The overall cesarean delivery rate was 30.

Respiratory morbidity in late preterm births.

Context: Late preterm births (340/7-366/7 weeks) account for an increasing proportion of prematurity-associated short-term morbidities, particularly respiratory, that require specialized care and prolonged neonatal hospital stays.

Objective: To assess short-term respiratory morbidity in late preterm births compared with term births in a contemporary cohort of deliveries in the United States.

Design, Setting, And Participants: Retrospective collection of electronic data from 12 institutions (19 hospitals) across the United States on 233,844 deliveries between 2002 and 2008.

Maternal and neonatal outcomes by labor onset type and gestational age.

Objective: We sought to determine maternal and neonatal outcomes by labor onset type and gestational age.

Study Design: We used electronic medical records data from 10 US institutions in the Consortium on Safe Labor on 115,528 deliveries from 2002 through 2008. Deliveries were divided by labor onset type (spontaneous, elective induction, indicated induction, unlabored cesarean).

The ability of the quadruple test to predict adverse perinatal outcomes in a high-risk obstetric population.

Objective: To determine the ability of the quadruple Down's syndrome screening test (quad screen) to predict other adverse perinatal outcomes (APO) in a high-risk obstetric population.

Setting: A tertiary medical centre in West Virginia.

Methods: We retrospectively reviewed 342 obstetric patients with quad screen data from a single clinic.

Ruptured tubal pregnancy associated with intrauterine pregnancy complicated by fetal holoprosencephaly: a case report.

Background: Naturally occurring heterotopic pregnancy is rare. A surviving intrauterine pregnancy associated with a ruptured tubal pregnancy is extremely unusual.

Case: This is the first reported case of a patient presenting in hemorrhagic shock due to a ruptured tubal pregnancy that was associated with an ongoing intrauterine pregnancy complicated by fetal holoprosencephaly.

The multiple challenges in the management of a patient with HELLP syndrome, liver rupture and eclampsia.

We report a case of a patient with HELLP syndrome, hemorrhagic shock due to liver rupture and late postpartum eclampsia superimposed on lupus nephropathy and chronic hypertension. This patient was delivered at 26 weeks by C-section. Aggressive and complex surgical and medical treatments were necessary to achieve hemostasis and stabilize the patient.