Evaluation and Significance of Nonvisualization of the Cavum Septum Pellucidum on Prenatal Ultrasonography.

Importance: The identification of the cavum septum pellucidum (CSP) is an integral part of the routine second trimester fetal anatomy scan. The absence or nonvisualization of the CSP has significant clinical implications and requires further evaluation and counseling for the pregnant patient.

Objective: The aim of this review is to review the importance of accurate sonographic identification of the CSP and the underlying pathologies that can be associated with nonvisualization of this structure.

Transvaginal Ovarian Cyst Drainage in Third Trimester to Facilitate Vaginal Delivery.

Adnexal masses in the third trimester of pregnancy may obstruct the pelvic outlet precluding labor induction and vaginal delivery. Expectant versus surgical management of adnexal cysts in pregnancy must carefully weigh maternal-fetal benefits and risks. Simple benign appearing cysts with low likelihood of malignancy may be amenable to percutaneous drainage as a bridge to interval postpartum laparoscopic cystectomy.

Syphilis in Pregnancy.

Importance: Since 2013, the United States has seen a rise in cases of congenital syphilis, culminating in a relative increase of 153% from 2013 to 2017 and 918 reported cases in 2017. In all, 50% to 80% of pregnant women with syphilis experience an adverse pregnancy outcome including stillbirth or spontaneous abortion.

Objective: This article aims to review the current evidence and recommendations for management of syphilis in pregnancy.

Pregnancy Outcomes Following Cervical Conization or Loop Electrosurgical Excision Procedures.

Background: Conservative excisional measures used to manage cervical dysplasia are often cited as risk factors for preterm labor in subsequent pregnancies.

Objective: We performed an evidence-based review of the obstetric complications following excisional procedures for cervical dysplasia in women of reproductive age.

Evidence Acquisition: Between 1993 and 2016, there were 7 published meta-analyses of cohort studies that consistently demonstrated an association between excisional cervical procedures and preterm labor.

Hepatitis C in Pregnancy: Review of Current Knowledge and Updated Recommendations for Management.

Importance: An estimated 1% to 2.5% of pregnant women in the United States are infected with hepatitis C virus (HCV), which carries approximately a 6% risk of mother-to-infant transmission.

Objectives: The aims of this article are to review the current evidence on HCV in pregnancy and to provide updated recommendations for management.

Risk Factors for Birth Defects.

Importance: Major congenital abnormalities, or birth defects, carry significant medical, surgical, cosmetic, or lifestyle consequences. Such abnormalities may be syndromic, involving multiple organ systems, or can be isolated. Overall, 2% to 4% of live births involve congenital abnormalities.

Ultrasound Examination of the Fetal Heart.

Congenital heart disease (CHD) occurs in 4-13 per 1000 births in the United States. While many risk factors for CHD have been identified, more than 90% of cases occur in low-risk patients. Guidelines for fetal cardiac screening during the second trimester anatomy ultrasound have been developed by the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) in order to improve antenatal detection rates and to standardize the fetal cardiac screening examination.

Pregnancy Management After Bariatric Surgery.

Obesity is a source of major morbidity and mortality and is a growing concern worldwide. Maternal obesity is associated with increased maternal and fetal risks during pregnancy. Bariatric surgery has emerged as one of the most sustainable treatments for severe obesity and its comorbidities.

Abnormalities of Fetal Situs: An Overview and Literature Review.

The incidence of congenital heart disease is most commonly reported in 8 per 1000 live births. Situs anomalies are among the least common forms of congenital heart disease. This study defines situs and describes the variations of fetal situs anomalies.

Perinatal Considerations in Women With Previous Diagnosis of Cancer.

As the average age that women have their first child increases and cancer therapies improve survival, obstetricians are more likely to care for pregnant women who have survived cancer. Managing these pregnancies can be challenging, as they may be associated with higher risks of maternal and neonatal morbidity and mortality. Different types of cancer require different types of intervention, including surgery, chemotherapy, radiation, or combinations of these.

Controversies in the Management of Isolated Congenital Atrioventricular Block.

Congenital atrioventricular block (CAVB) affects approximately 2% of fetuses of mothers with anti-Ro or anti-La antibodies, regardless of maternal rheumatologic symptoms. Anti-Ro and anti-La antibodies are antinuclear antibodies commonly found in autoimmune diseases. Congenital atrioventricular block is associated with a relatively high fetal morbidity and mortality, particularly more advanced degrees of block.

Characterization of antithrombin levels in pregnancy.

Objective: To characterize antithrombin (AT) levels in normal pregnancy.

Methods: We performed secondary analyses with data from 3 studies. Using a single measurement from each subject in the first analysis (cross-sectional), we correlated AT levels with gestational age from the middle of the second trimester throughout the third trimester of pregnancy.

Antenatal surveillance of fetal growth restriction.

Fetal growth restriction is a complex problem in modern obstetrics. It is a condition of suboptimal fetal growth based on a genetically predetermined potential and affects approximately 5% to 10% of pregnancies. It is traditionally defined as an estimated fetal weight less than the 10th percentile.

Influenza and tetanus, diphtheria, and acellular pertussis vaccinations during pregnancy.

Unlabelled: Vaccinations in pregnancy are an important aspect of prenatal care and of improving not only maternal health but also neonatal outcomes. Only 2 vaccines are specifically recommended during pregnancy: influenza and tetanus, diphtheria, and acellular pertussis (Tdap). Because influenza illness disproportionately affects pregnant women compared with other populations, annual prevention of influenza illness is recommended for all women who will be pregnant during influenza season (October to May).

Antidepressants in pregnancy: a review of commonly prescribed medications.

Unlabelled: Perinatal depression is an increasingly common comorbidity of pregnancy and is associated with adverse birth outcomes. Newer classes of antidepressants have been developed with a variety of mechanisms and improved side effect profiles. There is increasing use of these medications in reproductive-aged women.

The effects of magnesium sulfate on maternal and fetal platelet aggregation.

Objective: To evaluate platelet function in mothers and fetuses/neonates exposed to magnesium sulfate intrapartum.

Methods: This was a prospective cohort study of mothers and fetuses/neonates exposed to magnesium sulfate intrapartum compared to mothers and fetuses/neonates not exposed. Platelet aggregometry was performed in duplicate on specimens from subjects using two different agonists, ADP and collagen, on a whole blood impedance aggregometer.