Assessing the clinical utility of toxicology testing in the peripartum period.

Background: Toxicology testing is frequently used as a means of gathering objective data about substance use in pregnancy, but little is known about the clinical utility of testing in the peripartum setting.

Objective: This study aimed to characterize the utility of obtaining maternal-neonatal dyad toxicology testing at the time of delivery.

Study Design: We performed a retrospective chart review of all deliveries in a single healthcare system in Massachusetts between 2016 and 2020, and identified deliveries with either maternal or neonatal toxicology testing at delivery.

Human Herpesviruses 6A and 6B in Reproductive Diseases.

Human herpesviruses 6A (HHV-6A) and human herpesvirus 6B (HHV-6B)-collectively, HHV-6A/B-are recently-discovered but ancient human viruses. The vast majority of people acquire one or both viruses, typically very early in life, producing an ineradicable lifelong infection. The viruses have been linked to several neurological, pulmonary and hematological diseases.

Congenital thrombotic thrombocytopenic purpura (TTP) with placental abruption despite maternal improvement: a case report.

Background: Thrombotic thrombocytopenic purpura (TTP) is a rare but serious complication in pregnancy that places the mother and fetus at high risk for morbidity and mortality. This case illustrates novel pregnancy complications associated with this rare medical condition.

Case Presentation: A 31-year-old G3P0020 at 28 weeks and 1 day was admitted with severe thrombocytopenia and was ultimately diagnosed with TTP.

Patterns of Opioid Prescription and Use After Cesarean Delivery.

Objective: To define the amount of opioid analgesics prescribed and consumed after discharge after cesarean delivery.

Methods: We conducted a survey at six academic medical centers in the United States from September 2014 to March 2016. Women who had undergone a cesarean delivery were contacted by phone 2 weeks after discharge and participated in a structured interview about the opioid prescription they received on discharge and their oral opioid intake while at home.

Labor, delivery, and anesthesia experiences of women with physical disability.

Background: Although many women with physical disabilities report poor quality reproductive health care, little research has addressed labor, delivery, and anesthesia experiences of these women. This study was conducted to explore these experiences in women with significant mobility disabilities.

Methods: A qualitative descriptive study was conducted with 22 women from the United States who had delivered newborns within the prior 10 years.

Recommendations about Pregnancy from Women with Mobility Disability to Their Peers.

Background: Although growing numbers of women with mobility disability are becoming pregnant and desiring motherhood, relatively little is known about their pregnancy experiences or what they might recommend to other women with mobility disability contemplating pregnancy.

Methods: Using a semistructured, open-ended interview protocol, we conducted 2-hour telephone interviews with 22 women who had a significant mobility disability before becoming pregnant and had delivered babies within the prior 10 years. We recruited most interviewees through online social networks.

Severe maternal morbidity: screening and review.

This document builds upon recommendations from peer organizations and outlines a process for identifying maternal cases that should be reviewed. Severe maternal morbidity is associated with a high rate of preventability, similar to that of maternal mortality. It also can be considered a near miss for maternal mortality because without identification and treatment, in some cases, these conditions would lead to maternal death.

Association of Labor Induction With Offspring Risk of Autism Spectrum Disorders.

Importance: Induction of labor is a frequently performed obstetrical intervention. It would thus be of great concern if reported associations between labor induction and offspring risk of autism spectrum disorders (ASD) reflected causal influence.

Objective: To assess the associations of labor induction with ASD, comparing differentially exposed relatives (siblings and cousins discordant for induction).

Periviable birth: Interim update.

Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation.

Predictors of 30-day readmission following hysterectomy for benign and malignant indications at a tertiary care academic medical center.

Background: Hospital readmissions are costly, frequent, and increasingly under public scrutiny. With increased financial constraints on the medical environment, understanding the drivers of unscheduled readmissions following gynecologic surgery will become increasingly important to value-driven care.

Objective: The current study was conducted to identify risk factors for 30-day readmission following hysterectomy for benign and malignant indications.

#3: Periviable birth.

Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation.

Physical Accessibility of Routine Prenatal Care for Women with Mobility Disability.

Background: Routine prenatal care includes physical examinations and weight measurement. Little is known about whether access barriers to medical diagnostic equipment, such as examination tables and weight scales, affect prenatal care among pregnant women with physical disabilities.

Methods: We conducted 2-hour, in-depth telephone interviews with 22 women using a semistructured, open-ended interview protocol.

Calcium Channel Blocker Exposure in Late Pregnancy and the Risk of Neonatal Seizures.

Objective: To assess whether maternal calcium channel blocker exposure during late pregnancy is independently associated with neonatal seizures after carefully controlling for confounding factors.

Methods: Data were derived from the Medicaid Analytic eXtract for the years 2000-2007 and included 2,529,636 completed pregnancies. We compared the risk of neonatal seizures among neonates who were born to women who took calcium channel blockers in the final month of pregnancy to the risk in neonates born to women who did not use calcium channel blockers.

Diabetes Screening Reminder for Women With Prior Gestational Diabetes: A Randomized Controlled Trial.

Objective: To evaluate whether an electronic health record (EHR) reminder improves rates of screening for type 2 diabetes in women with prior gestational diabetes.

Methods: We randomly allocated primary care providers (by clinic site) to a reminder for type 2 diabetes screening within the EHR or to usual care. Women with previous gestational diabetes mellitus were identified through an automated search of laboratory results and the problem list.

"How did that happen?" Public responses to women with mobility disability during pregnancy.

Background: Little is known about current societal attitudes toward women with significant mobility disability who are visibly pregnant.

Objective: To use qualitative descriptive analysis methods to examine perceptions of women with significant mobility disability about how strangers reacted to their visible pregnancies.

Methods: In late 2013, we conducted 2-h telephone interviews with 22 women with significant mobility difficulties who had delivered babies within the prior 10 years.

Elevated upper body position improves pregnancy-related OSA without impairing sleep quality or sleep architecture early after delivery.

Background: During pregnancy, upper airway resistance is increased, predisposing vulnerable women to pregnancy-related OSA. Elevation of the upper body increases upper airway cross-sectional area (CSA) and improves severity of OSA in a subgroup of nonpregnant patients (positional-dependent sleep apnea). We tested the hypothesis that elevated position of the upper body improves OSA early after delivery.

Statins and congenital malformations: cohort study.

Objective: To examine the teratogenic potential of statins.

Design: Cohort study.

Setting: United States.