Relationship between body mass index and operative time in women receiving immediate postpartum tubal ligation.

Objectives: The aim of the study was to (1) assess the relationship between body mass index (BMI) and operative time during immediate postpartum tubal ligation procedures and to (2) determine whether operative time is non-inferior in women with BMI ≥30 versus women with BMI <30 and in women with BMI ≥40 versus women with BMI <40.

Study Design: We conducted a retrospective cohort study of women who received immediate postpartum tubal ligations following vaginal delivery from 2013 to 2017 at a university hospital. We abstracted demographic information, patient and procedural characteristics, and clinical outcomes.

Pregnant trauma victims experience nearly 2-fold higher mortality compared to their nonpregnant counterparts.

Background: Trauma is the leading nonobstetric cause of death in women of reproductive age, and pregnant women in particular may be at increased risk of violent trauma. Management of trauma in pregnancy is complicated by altered maternal physiology, provider expertise, potential disparate imaging, and distorted anatomy. Little is known about the impact of trauma on maternal mortality.

Cross-Cultural Obstetric and Gynecologic Care of Muslim Patients.

With the growing number of Muslim patients in the United States, there is a greater need for obstetrician-gynecologists (ob-gyns) to understand the health care needs and values of this population to optimize patient rapport, provide high-quality reproductive care, and minimize health care disparities. The few studies that have explored Muslim women's health needs in the United States show that among the barriers Muslim women face in accessing health care services is the failure of health care providers to understand and accommodate their beliefs and customs. This article outlines health care practices and cultural competency tools relevant to modern obstetric and gynecologic care of Muslim patients, incorporating emerging data.

Impact of fertility preservation counseling and treatment on psychological outcomes among women with cancer: A systematic review.

Background: For many female cancer survivors, the preservation of reproductive potential is central to quality of life (QOL), and concerns regarding infertility may affect treatment decisions. Despite the existence of several consensus guidelines supporting routine fertility preservation consultation, to the authors' knowledge little is known regarding psychological outcomes in female cancer patients who undergo fertility preservation counseling/consultation (FPC), with or without fertility preservation (FP).

Methods: This literature review examined the effect of FPC alone, or with FP, on psychological outcomes including satisfaction, decisional regret, and QOL.

Perioperative complications after live-donor hepatectomy.

Current studies of complications following donor hepatectomy may not be generalizable to all hospitals performing this procedure. To address this, live liver donors were identified in the Nationwide Inpatient Sample (2000-2008). Complications after donor hepatectomy were categorized using International Classification of Diseases, Ninth Revision codes and risk factors for complications were tested using logistic regression.

Uterine rupture after prior conservative management of placenta accreta.

Background: There is little evidence for counseling patients who seek uterine conservation in the setting of placenta accreta.

Case: We report the case of a 37-year-old woman with retained placenta accreta after vaginal delivery. Attempts at transvaginal removal failed, and the placenta was removed through a fundal hysterotomy with bilateral uterine artery ligations performed to control blood loss.

Sex trafficking of women and girls.

Sex trafficking involves some form of forced or coerced sexual exploitation that is not limited to prostitution, and has become a significant and growing problem in both the United States and the larger global community. The costs to society include the degradation of human and women's rights, poor public health, disrupted communities, and diminished social development. Victims of sex trafficking acquire adverse physical and psychological health conditions and social disadvantages.

Practice patterns and outcomes in retransplantation among pediatric kidney transplant recipients.

Background: More than 25% of pediatric kidney transplants are lost within 7 years, necessitating dialysis or retransplantation. Retransplantation practices and the outcomes of repeat transplantations, particularly among those with early graft loss, are not clear.

Methods: We examined retransplantation practice patterns and outcomes in 14,799 pediatric (ages <18 years) patients between 1987 and 2010.

Screening for intimate partner violence during pregnancy.

Intimate partner violence (IPV) is defined as an actual or threatened abuse by an intimate partner that may be physical, sexual, psychological, or emotional in nature. Each year approximately 1.5 million women in the United States report some form of sexual or physical assault by an intimate partner; it is estimated that approximately 324,000 women are pregnant when violence occurs.

Pregnancy after solid organ transplantation: a guide for obstetric management.

Successful pregnancy outcomes are possible among all solid organ transplant recipients. Patients should be fully counseled regarding the potential adverse fetal outcomes, including prematurity and low birth weight. Transplant recipients are at an increased risk for both maternal and neonatal complications and should be seen by a high-risk obstetrician in conjunction with their transplant teams.

Live donor champion: finding live kidney donors by separating the advocate from the patient.

Background: Lack of education and reluctance to initiate a conversation about live donor kidney transplantation is a common barrier to finding a donor. Although transplant candidates are often hesitant to discuss their illness, friends or family members are often eager to spread awareness and are empowered by advocating for the candidates. We hypothesized that separating the advocate from the patient is important in identifying live donors.

Pregnancy outcomes of liver transplant recipients: a systematic review and meta-analysis.

Approximately 14,000 women of reproductive age are currently living in the United States after liver transplantation (LT), and another 500 undergo LT each year. Although LT improves reproductive function in women with advanced liver disease, the associated pregnancy outcomes and maternal-fetal risks have not been quantified in a broad manner. To obtain more generalizable inferences, we performed a systematic review and meta-analysis of articles that were published between 2000 and 2011 and reported pregnancy-related outcomes for LT recipients.

Management of pregnant patients who refuse medically indicated cesarean delivery.

The doctrine of informed refusal may become difficult to adhere to in obstetric practice, especially in situations in which the fetus's life is at risk. One rare yet potentially problematic situation of informed refusal is the case of a pregnant woman who refuses to undergo a medically indicated cesarean delivery that would ensure the well-being of her fetus. Although some would argue that patient autonomy takes precedence and the woman's informed refusal should be respected, others would argue that beneficence, justice, and doing no harm to the viable fetus should ethically overrule the refusal of a surgery.

Potential limitations of presumed consent legislation.

A causal link has been proposed between presumed consent (PC) and increased donation; we hypothesized that too much heterogeneity exists in transplantation systems to support this inference. We explored variations in PC implementation and other potential factors affecting donation rates. In-depth interviews were performed with senior transplant physicians from 13 European PC countries.