PICC Lines in Pregnancy and Other Peripartum Vascular Access Considerations.

Importance: To decrease associated infectious and thrombotic morbidity, it is important to understand the indications and risks of peripherally inserted central catheters (PICCs) and other vascular access means in pregnancy.

Objectives: The objectives are 3-fold: (1) discuss indications and contraindications, approach to placement, and associated complications for PICC lines, arterial catheters, centrally inserted central catheters, and peripheral intravenous catheters; (2) review available data regarding complications associated with these catheters in pregnancy; and (3) propose an evidence-based approach to clinical decision making regarding vascular access in 2 clinical scenarios among pregnant patients.

Evidence Acquisition: A literature review identified relevant research, review articles, textbook chapters, databases, and societal guidelines, with a focus on obstetrical anesthesia and obstetric literature.

Perinatal Management of Hepatic Adenomas.

Importance: With a strong association between hepatic adenomas and estrogen established, understanding the risks, evaluation, and perinatal management of hepatic adenomas is necessary for obstetric clinicians.

Objective: The aim of this study is to review the preconception counseling, perinatal management, and postpartum care of hepatic adenomas.

Evidence Acquisition: A literature review identified relevant research, review articles, textbook chapters, databases, and societal guidelines.

Contemporary uses of "lethal" or "life limiting" terminology in perinatal research.

Purpose Of Review: A life-limiting fetal diagnosis (LLD) refers to a medical condition identified during pregnancy that is expected to lead to stillbirth, preclude ex utero survival, or significantly reduce neonatal life expectancy. The terms 'lethal' or 'life-limiting' are used to prognosticate early death for various anatomic or physiologic causes, although the expected timeframe is nonspecific. The purpose of this manuscript is to review how the terms 'lethal' or 'life limiting' are used in contemporary perinatal research.

Indomethacin and Cefazolin for Physical Exam-Indicated Cerclage to Improve Latency: A Protocol Validation Study.

Objective:  A single-center randomized trial showed improved latency with use of indomethacin and cefazolin (I/C) during and following exam-indicated cerclage (EIC). The same center recently published a pre/post comparison demonstrating similar results. This research aimed to validate the protocol in a different setting.

Caring for Pregnant Patients by Including Pregnant Participants.

AbstractPregnant research participants have long been excluded from early-stage clinical trials. This stance has been considered ethically justifiable because it upholds the principle of nonmaleficence by avoiding potential harm, using the fetus(es) as the point of reference. However, there are unintended consequences with this default approach.