Perinatal outcomes in grand multiparous women stratified by parity- A large multicenter study.

Objective: To assess the effect of each additional delivery among grand multiparous (GMP) women on maternal and neonatal outcomes.

Methods: A multi-center retrospective cohort study that examined maternal and neonatal outcomes of GMP women (parity 5-10, analyzed separately for each parity level) compared to a reference group of multiparous women (parity 2-4). The study population included grand multiparous women with singleton gestation who delivered in one of four university-affiliated obstetrical centers in a single geographic area, between 2003 and 2021.

Trial of labor after 2 previous cesareans: a multicenter study.

Background: Trial of labor after cesarean after 2 cesarean deliveries is linked to a lower success rate of vaginal delivery and higher rates of adverse obstetrical outcomes than trial of labor after cesarean after 1 previous cesarean delivery.

Objective: This study aimed to investigate the factors associated with failed trial of labor after cesarean among women with 2 previous cesarean deliveries.

Study Design: This was a multicenter retrospective cohort study, which included all women with singleton pregnancies attempting trial of labor after cesarean after 2 previous cesarean deliveries between 2003 and 2021.

[ADJUSTING THE DAYS OF BLEEDING AND PURITY FOR A BRIDE BEFORE THE WEDDING. THE RELIGIOUS FEMALE GYNECOLOGISTS CONFERENCE WAS HELD ON THE 15TH OF JULY 2021 IN JERUSALEM, AND AN ONLINE UPDATE CONFERENCE WAS HELD ON NOVEMBER 5TH 2022].

ADJUSTING THE DAYS OF BLEEDING AND PURITY FOR A BRIDE BEFORE THE WEDDING. THE RELIGIOUS FEMALE GYNECOLOGISTS CONFERENCE WAS HELD ON THE 15TH OF JULY 2021 IN JERUSALEM, AND AN ONLINE UPDATE CONFERENCE WAS HELD ON NOVEMBER 5TH 2022.

The Impact of Advanced Maternal Age on Pregnancy Outcomes: A Retrospective Multicenter Study.

The aim of this multicenter retrospective cohort study was to examine the impact of maternal age on perinatal outcomes in multiparas, stratified according to maternal age in one- and two-year increments. The analysis involved 302,484 multiparas who delivered between the years 2003 and 2021 in four university-affiliated obstetrics departments. Maternal age was considered both as a continuous variable and in two-year intervals, as compared with a comparison group of parturients aged 25-30 years.

Failed vacuum and preterm delivery risk in the subsequent pregnancy: a multicenter retrospective cohort study.

Background: Second-stage cesarean delivery is associated with subsequent preterm delivery. Failed vacuum-assisted delivery is a subgroup of second-stage cesarean delivery in which the fetal head is engaged deeper in the pelvis and, thus, is associated with an increased risk of short-term maternal complications.

Objective: This study aimed to investigate the maternal and neonatal outcomes of women at their subsequent delivery after a second-stage cesarean delivery with failed vacuum-assisted extraction vs after a second-stage cesarean delivery without a trial of vacuum-assisted extraction.

Induction of labor in twin pregnancy in patients with a previous cesarean delivery.

Background: Trial of labor after cesarean delivery (TOLAC) in twin gestations has been associated with decreased rates of successful vaginal delivery compared to singleton pregnancies, with mixed results regarding maternal and neonatal morbidity. However, induction of labor (IOL) in this unique population has not yet been fully evaluated.

Objective: To assess success rates and maternal and neonatal outcomes in women with a twin gestation and a previous cesarean delivery undergoing IOL.

Perinatal outcomes in nulliparous women with a history of multiple pregnancy losses according to number of previous pregnancy losses.

Background: While it is widely acknowledged that pregnancy losses can lead to negative outcomes for both mothers and fetuses, there is limited information available on the specific levels of risk associated with each additional pregnancy loss.

Objective: This study aimed to investigate the effect of number of previous pregnancy losses among nulliparous women on maternal and neonatal adverse outcomes.

Study Design: This was a multicenter retrospective cohort study.

The effectiveness of vaginal progesterone in reducing preterm birth in high-risk patients diagnosed with short cervical length after 24 weeks: A retrospective cohort study.

Objective: To assess the impact of progesterone treatment on maternal and neonatal outcomes in women with a history of preterm birth and short cervical length diagnosed after 24 weeks of gestation.

Methods: A retrospective cohort study included women with a history of preterm birth and a transvaginal sonographic cervical length measurement of ≤ 25 mm, diagnosed between 24 and 33 weeks of gestation. Exclusion criteria included prior progesterone treatment, cervical cerclage, or pessary.

Partogram of Grandmultiparous Parturients: A Multicenter Cohort Study.

Sparse and conflicting data exist regarding the normal partogram of grand-multiparous (GMP, defined as parity of 6+) parturients. Customized partograms may potentially lower cesarean delivery rates for protraction disorders in this population. In this study, we aim to construct a normal labor curve of GMP women and compare it to the multiparous (MP, defined as parity of 2-5) partogram.

Long-term gynecological complications after conservative treatment of placenta accreta spectrum.

Objective: To examine the association between conservative treatment for PAS (placenta accreta spectrum) and subsequent gynecological and fertility complications.

Methods: All women who underwent conservative treatment for PAS between January 1990 and December 2000 were included in this retrospective cohort study conducted in a tertiary teaching hospital. Gynecological and fertility complications experienced after the index delivery were collected from the medical records and telephone questionnaires.

Norethisterone Reduces Vaginal Bleeding Caused by Progesterone-Only Birth Control Pills.

(1) Background: Progesterone-only pills (POP) are widely used contraceptives. About 40% of women taking these pills report vaginal bleeding/spotting; 25% find this a reason for cessation. To date, no effective remedy has been described.

Trial of labor of vertex-nonvertex twins following a previous cesarean delivery.

Background: Maternal and neonatal outcomes of trial of labor after cesarean delivery of twins are similar to those of singleton trials of labor after cesarean delivery. However, previous studies did not stratify outcomes by second-twin presentation on admission to labor.

Objective: To examine maternal and neonatal outcomes following trial of labor after cesarean delivery in twins with vertex-nonvertex presentation.

Uterine rupture risk in a trial of labor after cesarean section with and without previous vaginal births.

Purpose: Previous cesarean delivery (CD) is the main risk factor for uterine rupture when attempting a trial of labor. Previous vaginal delivery (PVD) is a predictor for the trial of labor after cesarean (TOLAC) success and a protective factor against uterine rupture. We aimed to assess the magnitude of PVD as a protective factor from uterine rupture.

Transporting an Artificial Intelligence Model to Predict Emergency Cesarean Delivery: Overcoming Challenges Posed by Interfacility Variation.

Research using artificial intelligence (AI) in medicine is expected to significantly influence the practice of medicine and the delivery of health care in the near future. However, for successful deployment, the results must be transported across health care facilities. We present a cross-facilities application of an AI model that predicts the need for an emergency caesarean during birth.

Normal labor curve in twin gestation.

Background: Failure to progress is one of the leading indications for cesarean delivery in trials of labor in twin gestations. However, assessment of labor progression in twin labors is managed according to singleton labor curves.

Objective: This study aimed to establish a partogram for twin deliveries that reflects normal and abnormal labor progression and customized labor curves for different subgroups of twin labors.

The impact of peak and duration of maternal intrapartum fever on perinatal outcomes.

Background: Intrapartum fever is a common perinatal complication, associated with short- and long-term adverse outcomes. Limited data exist regarding the association between the peak and duration of maternal fever and the extent and severity of maternal and neonatal complications.

Objective: This study aimed to examine the association between maternal intrapartum fever peak and duration and perinatal outcomes.

Induction of labor in women with a scarred uterus: does grand multiparity affect the risk of uterine rupture?

Background: Previous cesarean delivery is the most important risk factor for subsequent uterine rupture. Data are inconsistent regarding grand multiparity (≥6th delivery) and a risk for uterine rupture. Specifically, no data exist regarding the risk that is associated with labor induction or augmentation in grand multiparous women after cesarean delivery.

Cervical dilation at the time of epidural catheter insertion is not associated with the degree of prolongation of the first or second stages of labor, or the rate of instrumental vaginal delivery.

Introduction: Epidural analgesia (EA) is an established option for efficient intrapartum analgesia. Meta-analyses have shown that EA differentially affects the first stage of labor but prolongs the second. The question of EA timing remains open.

Grandmultiparity, maternal age, and the risk for uterine rupture-A multicenter cohort study.

Introduction: Uterine rupture is a critical complication causing fetal and maternal morbidity and mortality. Data are conflicting regarding whether grandmultiparity (parity ≥ 6) is a risk factor. This multicenter cohort study aimed to determine whether grandmultiparity (parity ≥ 6) poses a risk for uterine rupture in women with no previous cesarean delivery.

Safety of trial of labor after cesarean delivery in grandmultiparous women.

Objective: To evaluate the risk of uterine rupture and other major labor complications in a trial of labor after cesarean delivery (TOLAC) in grandmultiparous women.

Methods: A retrospective descriptive study of 64,345 births in three hospitals between the years 1999 and 2009. The study group included 1,922 deliveries of women in their sixth or higher birth with one previous cesarean delivery.