Cesarean wound closure in body mass index 40 or greater comparing suture to staples: a randomized clinical trial.

Background: Cesarean delivery is the most common major surgical procedure performed in the United States. Women with class III obesity have an increased risk of cesarean delivery and have wound complication rates higher than healthy body mass index counterparts. Available evidence regarding optimal wound closure is lacking specific to the population of women with class III obesity despite a known increased rate of wound complications.

Robotic Transabdominal Cerclage vs Laparotomy: A Comparison of Obstetric and Surgical Outcomes.

Study Objective: To compare obstetric and surgical outcomes of transabdominal cerclage (TAC) via laparotomy (TAC-LAP) versus robotic-assisted (TAC-RA) approaches.

Design: Retrospective cohort study.

Setting: An academic medical center.

Vasa previa: diagnosis and management.

Background: Vasa previa is a rare condition that is associated with a high rate of fetal or neonatal death when not diagnosed antenatally. The majority of available studies are either small, do not include antepartum data, limited to single institutions, or are biased by inclusion of patients from registries and online vasa previa support groups.

Objective: The purpose of this study was to investigate the diagnostic and management strategies for this potentially catastrophic entity and to describe further maternal and placental risk factors that may aid in the establishment of a screening protocol for vasa previa.

Obesity and pregnancy: clinical management of the obese gravida.

In recent years, the prevalence of obesity in the United States has risen dramatically, especially among women of reproductive age. Research that has specifically evaluated pregnancy outcomes among obese parturients has allowed for a better understanding of the myriad adverse perinatal complications that are observed with significantly greater frequency in the obese pregnant population. The antepartum, intrapartum, intraoperative, postoperative, and postpartum periods are all times in which the obese pregnant woman is at greater risk for adverse maternal-fetal outcomes, compared with her ideal bodyweight counterpart.

Umbilical artery aneurysm.

Background: Umbilical artery aneurysm is a rare condition associated with increased risk for aneuploidy and fetal demise.

Case: We report a case of umbilical artery aneurysm discovered at 27 weeks of gestation in one fetus of a dichorionic, diamniotic twin pregnancy. The patient was hospitalized to monitor for expansion of the aneurysm.

Blunt suture needle use in laceration and episiotomy repair at vaginal delivery.

Objective: By surveying obstetricians regarding the use of blunt suture needles for laceration and episiotomy repair, the purpose of this study was to determine whether blunt suture needles represent a safe and effective alternative to sharp needles.

Study Design: Blunt suture needles were made available at our institution for repairs at vaginal delivery. Participating physicians indicated their personal history of needlestick injuries and rated the blunt suture needle after completing the repair.

Patients' knowledge of umbilical cord blood banking.

Objective: To determine patients' knowledge of umbilical cord blood banking (UCBB).

Methods: A questionnaire was administered. Part 1 queried issues of familiarity with the term UCBB.

Klippel-Trenaunay-type syndrome in pregnancy.

Introduction: Klippel-Trenaunay-Type Syndrome (KTTS) is a rare congenital anomaly with variable expression and an unknown etiology characterized by capillary and venous malformations and hypertrophy of bone and soft tissue. Pregnancy has been rarely reported in patients with KTTS and since 1989 there have been only 13 case reports of pregnancy in women with KTTS reported in the literature. Concurrent pregnancy is associated with adverse perinatal outcomes.

Association of vasa previa at delivery with a history of second-trimester placenta previa.

Objective: To evaluate whether vasa previa at delivery is associated with a history of second-trimester placenta previa.

Study Design: Retrospective, case-control study of all vasa previa cases at Good Samaritan Regional Medical Center from January 1, 1991, to May 1, 2001. Cases were identified by ICD-9 codes and confirmed by chart review.

Complications associated with peripherally inserted central catheter use during pregnancy.

Objective: The purpose of this study was to evaluate the complications of peripherally inserted central catheter use in an obstetrics population at a single institution over a 5-year period.

Study Design: We conducted a descriptive retrospective review of all obstetrics patients with peripherally inserted central catheter insertion during the antepartum period at Good Samaritan Regional Medical Center, from January 1, 1997, through September 30, 2001.

Results: During the 5 years of the study, complete data regarding the primary admission diagnoses for peripherally inserted central catheter placement and associated complications were available for 52 cases.