Metoclopramide and Diphenhydramine: A Randomized Controlled Trial of a Treatment for Headache in Pregnancy when Acetaminophen Alone Is Ineffective (MAD Headache Study).

Objective: We investigated whether metoclopramide administered with diphenhydramine (MAD) relieves headache in pregnant women when acetaminophen alone is ineffective, using codeine for comparison.

Study Design: Normotensive pregnant women in the second or third trimester were randomized to MAD intravenously (10 mg and 25 mg, respectively) or codeine orally (30 mg) for headache after 650 to 1,000 mg of acetaminophen failed to relieve their headaches. Headache severity (pain score 0-10) was noted at intervals over 24 hours.

A barrier retractor to reduce surgical site infections and wound disruptions in obese patients undergoing cesarean delivery: a randomized controlled trial.

Background: Surgical site infections (SSIs) are an important cause of morbidity following cesarean delivery, particularly in obese patients. Methods to reduce SSIs after cesarean delivery would have an important impact in obese obstetric patients.

Objective: The purpose of this study was to determine whether the Alexis O cesarean delivery retractor, a barrier self-retaining retractor, reduces SSIs and wound disruptions in obese patients undergoing cesarean delivery.

The third stage of labor: a study of outcomes in the second trimester of pregnancy.

Objective: To evaluate the length of the third stage of labor in second trimester pregnancies, to determine the rate of complications such as hemorrhage or infection, and to determine the ideal timing for delivery of the placenta in these pregnancies.

Study Design: A review of 121 consecutive vaginal deliveries between 16 and 27 gestational weeks was performed. Length of the third stage of labor was determined, as well as the composite endpoint of need for manual or instrumented removal of the placenta, or development of chorioamnionitis or endometritis.

Baking soda pica associated with rhabdomyolysis and cardiomyopathy in pregnancy.

Background: Pica is a commonly underappreciated disorder in pregnancy that can lead to several complications, including severe metabolic derangements and other adverse outcomes. We report a case of baking soda pica in pregnancy associated with both rhabdomyolysis and cardiomyopathy.

Case: A multigravid woman at 37 weeks of gestation presented with weakness and severe hypokalemia.