Ornithine transcarbamylase deficiency and pregnancy: A case series and review of recommendations.

Background: Ornithine transcarbamylase deficiency (OTCD) is a rare disorder of the urea cycle that obstetricians should be aware of in order to guide management for pregnant carriers of the X-linked gene that causes the condition.

Cases: We present the pregnancy management and outcomes of two women with OTCD. The particular manifestations of the disease drive antenatal, intrapartum and postpartum management.

Maternal morbidity after early preterm delivery (23-28 weeks).

Background: Previous research has focused mainly on neonatal outcomes associated with preterm and periviable delivery, but maternal outcomes with preterm delivery are less well described.

Objective: This study aimed to determine if early preterm delivery results in an increase in maternal morbidity.

Study Design: This is a retrospective cohort study conducted at a tertiary care center over a 5-year time period.

Factors associated with attendance at the postpartum blood pressure visit in pregnancies complicated by hypertension.

Objectives: Women with hypertensive disorders of pregnancy should have a blood pressure evaluation no later than 7-10 days after delivery. The objective of this study was to identify the factors associated with patient attendance at the postpartum blood pressure follow-up visit.

Study Design: This was a retrospective cohort study of postpartum women who had a hypertensive disorder of pregnancy.

Maternal antepartum antibiotic administration and patterns of bacterial resistance in early preterm neonates.

Objective: The objective of this study was to determine the relationship between maternal antepartum antibiotic administration and antibiotic resistance patterns in preterm neonates admitted to the neonatal intensive care unit (NICU).

Methods: This was a retrospective cohort study of women and their preterm neonates delivered at a single tertiary care center over a 5-year period. Women and neonates were included if they delivered between 23 weeks 0 days and 28 weeks 6 days of gestation and neonates were admitted to the NICU.

Evaluation and Treatment of Cardiac Tamponade in a Pregnant Patient.

Cardiac tamponade is an uncommon but life-threatening emergency that may occur in pregnant women. There is a plethora of causes, but prompt diagnosis and intervention is imperative to optimize both maternal and fetal outcomes. We report on a case of a large pericardial effusion leading to cardiac tamponade occurring in the 32 week of gestation in a previously healthy woman.

Challenges and opportunities to understand, discuss, and decrease maternal mortality rates in the United States. The New Jersey experience.

Maternal mortality improvement depends on the proper classification used in defining maternal deaths. Since there are several definitions of maternal deaths depending upon the proximate cause of the death, if the death is related to the physiologic changes during pregnancy or not and the timing of the death, some opportunities for improvement may be missed to decrease the overall maternal mortality rate in the USA if the correct definition is not utilized appropriately.

Genital tract GBS and rate of histologic chorioamnionitis in patients with preterm premature rupture of membrane.

Introduction: Histologic chorioamnionitis (HC) is a common finding in the placenta from patients with preterm premature rupture of membranes (PPROM). The purpose of this study is to determine if HC differs based on the Group B streptococcus (GBS) status in patients managed expectantly with PPROM <34 weeks gestation.

Methods: A retrospective study was performed of patients admitted with PPROM between 23 0/7 and 33 6/7 weeks from 2003 to 2014 at one institution.

Procalcitonin in amniotic fluid at the time of genetic amniocentesis and preterm delivery.

Purpose: Procalcitonin (PCT) is an acute-phase protein that has been infrequently studied in amniotic fluid. We sought to determine if PCT levels measured in amniotic fluid samples at the time of genetic amniocentesis are predictive of preterm delivery.

Materials And Methods: A retrospective cohort study was performed on all women presenting for genetic amniocentesis between 15-23 weeks of pregnancy at our institution from 2011 to 2013 with stored amniotic fluid samples.

Serotype Typhi Bacteremia Complicating Pregnancy in the Third Trimester.

. serotype Typhi ( Typhi) is an anaerobic gram-negative enteric rod that causes infection when contaminated food or water is ingested and may cause illness in pregnancy. .

Is preeclampsia an independent predictor of diastolic dysfunction? A retrospective cohort study.

Objective: To determine if preeclampsia is an independent predictor of diastolic dysfunction and what factors among patients with preeclampsia are associated with diastolic dysfunction.

Methods: This is a retrospective cohort study of patients who delivered between 2008 and 2013 at a single institution who had a maternal echocardiogram during their pregnancy or within 5months of delivery. Patients with structural heart disease, ejection fraction less than 45%, pulmonary embolus, or age over 45years were excluded.

Labor outcomes of obese patients undergoing induction of labor with misoprostol compared to dinoprostone.

Objective: The aim of the article is to evaluate and compare labor outcomes in obese patients undergoing induction of labor (IOL) with misoprostol and dinoprostone.

Study Design: This was a retrospective review of patients who delivered from February 1, 2008, to July 1, 2013 at our institution. All obese women who underwent IOL were identified.

Does preeclampsia predict the risk of late postpartum eclampsia?

Objective To investigate potential predictive symptoms of late postpartum eclampsia (LPE). Study Design Retrospective review of patients delivered at a single academic medical center and diagnosed with eclampsia greater than 48 hours postdelivery. Results Among 19 patients with eclampsia, 5 (26%) patients with confirmed eclampsia seized greater than 48 hours after delivery.

Does genital tract GBS colonization affect the latency period in patients with preterm premature rupture of membranes not in labor prior to 34 weeks?

Objective: To determine if genital tract colonization with GBS at the time of preterm premature rupture of membranes (PPROM) affects the latency period.

Study Design: A retrospective cohort study was performed of all gravidas admitted with PPROM between 23 and 34 weeks of gestation from 1 January 2003 to 29 February 2012. Vaginal/rectal specimens for GBS were performed on admission.

Obesity, comorbidities, and the cesarean delivery rate.

Objective: To evaluate the effect of comorbidities and induction of labor (IOL) on the cesarean delivery (CD) rate in an obese nulliparous cohort.

Study Design: This was a retrospective review of medical records of patients who delivered at our institution from January 1, 2010, to January 18, 2011. Nulliparous patients were identified with a body mass index of ≥ 30.

Chronic hepatitis B infection: a workshop consensus statement and algorithm.

Here, presented with an evidence-based algorithm, are workshop consensus recommendations on whom to screen for hepatitis B and when to pursue further evaluation and management.

Ertapenem compared to combination drug therapy for the treatment of postpartum endometritis after cesarean delivery.

Objective: Ertapenem is a broad spectrum carbapenem approved for the treatment of postpartum endometritis. Data regarding clinical outcomes after treatment with ertapenem for endometritis after cesarean delivery are limited. Our objectives were to compare clinical outcomes and cost of ertapenem versus a multi-drug regimen for treatment of endometritis after cesarean delivery.

Prenatal diagnosis of bilateral dacryocystocele using 3-D/4-D ultrasound technology: a case report.

Background: Bilateral dacryocystoceles develop as a result of obstruction of the nasolacrimal canal. The advances in obstetric sonography have led to increased diagnosis of this structural defect in the antenatal period as early as 24 weeks' gestation.

Case: We describe a case of bilateral dacryocystocele with clear visualization of this defect using 3-D/4-D sonography.

The influence of race on the incidence of respiratory distress syndrome after antenatal betamethasone or dexamethasone.

Objective: To compare the incidence of respiratory distress syndrome (RDS) in African American and Caucasian neonates after antenatal betamethasone or dexamethasone.

Study Design: This was a retrospective review of all deliveries occurring at < or = 32 weeks' gestation at Hackensack University Medical Center from 2001 to 2004. Only patients who received a complete course of antenatal steroids were included.

Maternal obesity and associated reproductive consequences.

The prevalence of obesity is continuing to increase among women. Women who are in their reproductive years are disproportionately affected by obesity. The link between obesity and increased morbidity from various conditions, including cardiovascular disease, Type 2 diabetes, osteoarthritis and malignancies, is well established.

Asymptomatic bacteriuria in pregestational diabetic pregnancies and the role of group B streptococcus.

We sought to determine if gravidas with pregestational diabetes mellitus (DM) are at increased risk for asymptomatic bacteriuria (ASB) compared with nondiabetic gravidas. This is a retrospective case-control study of 150 pregnant patients with pregestational DM and 294 nondiabetic controls. Rates of ASB and any colony count of group B streptococcus (GBS) bacteriuria were reviewed.

Glutaric aciduria type II and narcolepsy in pregnancy.

Background: Glutaric aciduria type II is a rare disorder affecting the metabolism of fatty acid oxidation and several mitochondrial dehydrogenase enzymes. Narcolepsy and cataplexy is a disorder affecting sleep cycles and rapid eye movement activity. There is little information on outcome or management for either disorder in pregnancy.

Preterm premature rupture of membranes in pregnancies complicated by human immunodeficiency virus infection: a single center's five-year experience.

Objective: The objective of this study was to describe one center's five-year experience of the management of human immunodeficiency virus (HIV) positive gravidas with preterm premature rupture of the membranes (PPROM) not in labor at
Methods: This is a retrospective chart review of all HIV positive gravidas with PPROM at
Results: We identified 228 HIV positive gravidas of whom 19 had PPROM at View Article and Find Full Text PDF

Shoulder dystocia related fetal neurological injuries: the predisposing roles of forceps and ventouse extractions.

On the basis of 333 documented cases of permanent perinatal neurological damage, associated with arrest of the shoulders at birth, the authors conducted a retrospective study in order to evaluate the predisposing role, if any, of the utilization of extraction instruments. The investigation revealed that 35% of all injuries occurred in neonates delivered by forceps, ventouse or sequential ventouse-forceps procedures. This frequency was several-fold higher than the prevailing instrument use in the practices of American obstetricians during the same years.