Outcomes of Uterine Rupture in the Setting of the Unscarred Compared With the Scarred Uterus.

Uterine rupture is a rare obstetric complication that is associated with maternal and neonatal morbidity and mortality. The aim of this study was to examine uterine rupture and its outcomes in the setting of the unscarred compared with the scarred uterus. A retrospective observational cohort study was performed examining all cases of uterine rupture in three tertiary care hospitals in Dublin, Ireland, over a 20-year period.

Assessment of antenatal anxiety, depression and obsessive-compulsive disorder in pregnant women in the COVID-19 era.

Objective: To assess the mental health of pregnant women, with reference to anxiety, depression and obsessive-compulsive (OC) symptoms, during the COVID-19 pandemic.

Methods: A cross-sectional survey was conducted in Ireland during the third wave of the pandemic between February and March 2021. Psychiatric, social and obstetric information was collected from pregnant women in a Dublin maternity hospital, alongside self-reported measures of mental health status.

Anxiety and depression scores in maternity healthcare workers during the Covid-19 pandemic.

Healthcare workers are at significant risk of psychological morbidity during the COVID‐19 pandemic. Anxiety and depression is highest in young, female, and supportive workers.

Use of the Robson Ten Group Classification System to categorise operative vaginal delivery.

Background: Operative vaginal delivery (OVD), either vacuum or forceps, can be used to expedite vaginal delivery. While rates of OVD have been reducing worldwide, rates in Ireland remain high. The Robson Ten Group Classification System (TGCS) was originally created to compare rates of caesarean delivery between healthcare units, although no similar system exists for the analysis of OVD.

Anal Sphincter Injury Associated with Vaginal Twin Delivery.

Objective: Obstetric anal sphincter injury remains the most common cause of fecal incontinence in women, and research in twin pregnancies is sparse. This study aimed to examine risk factors for sphincter injury in twin deliveries over a 10-year period.

Study Design: This was a retrospective study of twin vaginal deliveries in a tertiary-level hospital over 10 years.

Antecedents of red cell transfusion in a large contemporary obstetric cohort.

Background Hemorrhage is a critical contributor to maternal morbidity but estimation of blood loss at delivery is frequently inaccurate. Due to this inaccuracy we sought to examine blood transfusion as a surrogate marker for morbidity in a large non-population based consecutive cohort. Methods A retrospective analysis of prospectively gathered data was carried out at two university institutions serving a heterogeneous urban obstetric population from January to December 2016.

Influence of mode of delivery on outcomes in preterm breech infants presenting in labor.

Rates of vaginal breech delivery at term have fallen significantly. We sought to examine rates of preterm vaginal breech delivery and outcomes associated with delivery route. This retrospective cohort study was carried out at a large tertiary referral center serving an urban population, from 2001 to 2011.

Cesarean delivery in the United States 2005 through 2014: a population-based analysis using the Robson 10-Group Classification System.

Background: Cesarean delivery has increased steadily in the United States over recent decades with significant downstream health consequences. The World Health Organization has endorsed the Robson 10-Group Classification System as a global standard to facilitate analysis and comparison of cesarean delivery rates.

Objective: Our objective was to apply the Robson 10-Group Classification System to a nationwide cohort in the United States over a 10-year period.

The presentation and management of platelet disorders in pregnancy.

Thrombocytopenia, defined as a platelet count less than 150 000 per microlitre, occurs in 7%-12% of all pregnancies. Apart from anaemia, it is the most common haematological disorder in pregnancy. Despite its frequent occurrence, thrombocytopenia often leads to difficulties of diagnosis and management in pregnancy.

Second-Stage Duration and Outcomes Among Women Who Labored After a Prior Cesarean Delivery.

Objective: To characterize probabilities of vaginal delivery based on second-stage duration along with maternal and neonatal risks for women undergoing labor after cesarean delivery.

Methods: This unplanned secondary analysis of the Maternal-Fetal Medicine Units Cesarean Registry, a prospective observational cohort, assessed outcomes in women with a prior uterine scar and included women with a previous cesarean delivery without prior vaginal delivery who reached the second stage of labor. The primary outcome was mode of delivery by second-stage duration.

SMFM Special Report: Putting the "M" back in MFM: Reducing racial and ethnic disparities in maternal morbidity and mortality: A call to action.

Racial and ethnic disparities in maternal morbidity and mortality rates are an important public health problem in the United States. Because racial and ethnic minorities are expected to comprise more than one-half of the US population by 2050, this issue needs to be addressed urgently. Research suggests that the drivers of health disparities occur at 3 levels: patient, provider, and system.

Anal sphincter injury in vaginal deliveries complicated by shoulder dystocia.

Introduction And Hypothesis: Shoulder dystocia is an obstetric emergency that occurs in 0.2-3% of all cephalic vaginal deliveries. We hypothesized that because of the difficult nature of deliveries complicated by shoulder dystocia, the condition may be associated with anal sphincter injury.

Prenatal prediction of significant intertwin birthweight discordance using standard second and third trimester sonographic parameters.

Introduction: Our study aim was to evaluate standard ultrasound-derived fetal biometric parameters in the prediction of clinically significant intertwin birthweight discordance defined as ≥18%.

Material And Methods: This was a secondary analysis of a prospective cohort study of 1028 unselected twin pairs recruited over a two-year period. Dichorionic twins underwent two-weekly ultrasonographic surveillance from 24 weeks' gestation, with surveillance of monochorionic twins two-weekly from 16 weeks.

Perinatal death associated with umbilical cord prolapse.

Objective: Umbilical cord prolapse occurs when the cord prolapses ahead of or alongside the presenting part. It is an acute obstetric emergency with potential catastrophic effects. We set out to assess incidence of cord prolapse, as well as rates and characteristics of perinatal death associated with the condition.

Severe maternal morbidity and comorbid risk in hospitals performing <1000 deliveries per year.

Background: While research has demonstrated increasing risk for severe maternal morbidity in the United States, risk at lower volume hospitals remains poorly characterized. More than half of all obstetric units in the United States perform <1000 deliveries per year and improving care at these hospitals may be critical to reducing risk nationwide.

Objective: We sought to characterize maternal risk profiles and severe maternal morbidity at low-volume hospitals in the United States.

Simplified and standardized intrapartum management can yield high rates of successful VBAC in spontaneous labor.

Objective: To examine the outcomes of vaginal birth after cesarean (VBAC) in women, in spontaneous labor, delivering after 37 weeks' gestation at an institution where trial of labor after a previous cesarean delivery (TOLAC) is encouraged and management of labor is standardized.

Methods: This retrospective cohort study included 3071 women with one previous cesarean only and no vaginal delivery who underwent a trial of labor from 2001 to 2011. Women were managed using the standardized "active management of labor" intrapartum protocol.

Gestational hypertensive disease in twin pregnancy: Influence on outcomes in a large national prospective cohort.

Objective: Gestational hypertensive disease (GHD) is associated with pregnancy-related complications and poor maternal and fetal outcomes in singleton pregnancies. We sought to examine the influence of GHD in a large prospective cohort of twin pregnancies.

Study Design: The ESPRIT study was a national multicenter observational cohort study of 1028 structurally normal twin pregnancies.

Paeoniflorin, a novel heat-shock protein inducing compound, and human myometrial contractility in vitro.

Aim: Heat shock proteins (HSPs) are synthesized in virtually all organisms in response to increases in temperature. They are associated with a relaxant effect on the human myometrium and are present in decreased concentration in the myometrium at the time of labor. Paeoniflorin is derived from Paeonia lactiflora and has been shown to induce the synthesis of HSPs in cultured mammalian cells.