The Contribution of Neighborhood Context to the Association of Race with Severe Maternal Morbidity.

Objective: Severe maternal morbidity (SMM) has disproportionate frequencies among racial minorities and those of socioeconomic disadvantage, with people of Black race consistently having the highest proportion. Neighborhood level deprivation has been associated with maternal morbidity and mortality, including adverse pregnancy outcomes. We sought to explore the relationship between neighborhood socioeconomic disadvantage and SMM and describe how neighborhood context impacts the relationship between race and SMM.

Implementation of a universal postpartum blood pressure monitoring program: feasibility and outcomes.

Background: New-onset postpartum preeclampsia has a higher risk of maternal morbidity and mortality than preeclampsia with antepartum onset, underscoring the need for earlier identification of elevated blood pressure among patients with this condition. Given the decrease in healthcare engagement, which is typical of the postpartum period, new-onset postpartum hypertension often goes unrecognized. Currently, there are no recommendations for universal postpartum blood pressure surveillance in women without hypertensive disorders of pregnancy.

Comparative Analysis of Obstetric Hemorrhage Risk Prediction Tools.

Objective: Hemorrhage risk prediction tools were developed in response to rising rates of obstetric hemorrhage (OBH). The California Maternal Quality Care Collaborative (CMQCC) risk prediction tool classifies patients as low, medium, and high risk for OBH based on individual risk factors. At our institution, Magee-Womens Hospital (MWH), a unique OBH risk prediction tool was derived from the CMQCC tool that differs through its use of weighted risk factors and distinctive laboratory value cutoffs.

Lessons Learned From a Gap Analysis of Obstetric Hemorrhage Protocols across a Health System.

Introduction: The United States has experienced a rising incidence of maternal deaths, including those attributable to obstetric hemorrhage (OBH). In response, the National Partnership for Maternal Safety developed a standardized OBH Consensus Bundle with the goal of universal adoption. In 2016 a large western Pennsylvania health system adopted the OBH Consensus Bundle across its 8 obstetrical units, with the goal to improve maternal outcomes.

Isolated echogenic intracardiac foci and the role of cell-free fetal DNA: A cost-effectiveness analysis.

Objectives: Cell-free fetal DNA (cfDNA) has been increasingly incorporated into prenatal aneuploidy screening paradigms given its relatively high sensitivity for Down syndrome (DS). This is often the case when fetal ultrasonographic soft markers are present, such as the relatively common echogenic intracardiac focus (EIF). We sought to evaluate the cost-effectiveness of a screening strategy that included cfDNA screening when an isolated EIF is identified in a low-risk population with prior aneuploidy screening.

Maternal and fetal outcomes of pancreatitis in pregnancy.

Objective: This study examined maternal and neonatal outcomes that are associated with pancreatitis in pregnancy, in particular preeclampsia.

Study Design: We conducted a retrospective cohort study of all singleton nonanomalous pregnancies in California from 2005-2008 with an identification of all cases of pancreatitis. Outcomes of interest included preeclampsia, intrauterine fetal death, preterm delivery, and neonatal or infant death.

Very late complications of cervical arthroplasty: results of 2 controlled randomized prospective studies from a single investigator site.

Study Design: Prospective, single-site, randomized, Food and Drug Administration-approved investigational device exemption clinical trials of 2 cervical arthroplasty (CA) devices.

Objective: To evaluate complications with CA occurring more than 4 years after the surgical procedure in Food and Drug Administration clinical trials of the Bryan and Prestige LP arthroplasty devices.

Summary Of Background Data: Reports of several randomized clinical studies have shown CA to be a safe and effective alternative to anterior cervical fusion in the treatment of degenerative cervical disc disorders.