Sharing of Snorting Straws and Hepatitis C Virus Infection in Pregnant Women.

Objective: To evaluate possible modes of hepatitis C virus (HCV) acquisition in pregnant women found to be HCV-infected in the prenatal period and to assess transmission risk factors.

Methods: This was a prospective cohort study conducted from March 2014 through June 2015 involving the distribution of an anonymous survey to HCV-infected pregnant women that assessed for numerous modes of potential HCV transmission involving, intravenous drug use, blood transfusion, organ transplant, sexual contact, tattoos, and snorting drugs with a straw. Participants were drawn from our institutional obstetric high-risk clinic.

Detoxification from opiate drugs during pregnancy.

Background: The current recommendation regarding the management of a pregnant patient with opioid dependence is not to perform detoxification during pregnancy because of a potential risk for preterm labor, fetal distress, or fetal demise.

Objective: The objective of the study was to evaluate the safety of full opiate detoxification during pregnancy in a large number of patients through 4 different methods and analyze the rate of newborn treatment of neonatal abstinence syndrome for each method.

Study Design: This was a retrospective analysis of data collected prospectively during ongoing prenatal care of opiate-addicted pregnant women.

Blood Contaminated Amniotic Fluid and the Lamellar Body Count Fetal Lung Maturity Test.

Objective: To determine if maternal blood contamination falsely elevates the lamellar body count fetal lung maturity test.

Study Design: Fifty mothers undergoing amniocentesis for fetal lung maturity consented to participation in the study. For each participant a blood-contaminated sample using the patient's own blood was run in tandem with the noncontaminated sample used for clinical practice.

The use of prostaglandin E₁ in peripartum patients with asthma.

Objective: Prostaglandin E₁ (PGE₁) is commonly used in obstetric practice for labor induction and cervical ripening and in treating postpartum hemorrhage; however, its use in pregnant asthmatic patients has not been studied to date. The package insert states there is an unknown causal side effect for dyspnea and bronchospasm. Other pharmacological publications have stated that bronchoconstriction may occur with the use of PGE₁.

Accuracy of the lamellar body count in amniotic fluid contaminated by meconium.

Objective: To determine whether meconium-contaminated amniotic fluid falsely elevates the lamellar body count in fetal lung maturity testing.

Methods: Thirty mothers undergoing amniocentesis for fetal lung maturity testing were prospectively consented. A 2 mL portion of the patient's sample was mixed with a 10% meconium solution and the meconium-stained sample was then run in tandem with the patient's sample used in clinical management.

Transplacental passage of vancomycin from mother to neonate.

Objective: The objective of the study was to analyze a large number of patients receiving vancomycin chemoprophylaxis and evaluate the maternal and neonatal cord blood levels at the time of delivery.

Study Design: Every mother who entered labor with a positive group B streptococcal culture and a high-risk penicillin allergy with resistance to clindamycin or unknown sensitivity was consented to participate in the study. In the initial phase of the study, patients received the standard intravenous dose of 1 g every 12 hours.

Vagal nerve stimulator use during pregnancy for treatment of refractory seizure disorder.

Background: In patients with medically refractory seizures, vagal nerve stimulation is becoming an increasingly common adjunctive therapy. Although its safety and efficacy have been proven in the general population, little is known about its use during pregnancy.

Case: A 19-year-old primigravid woman presented during the first trimester for routine prenatal care.