Perinatal mortality trend associated with maternal obesity in United States between 2015 - 2020.

Background: Obesity is associated with an increased risk of stillbirth and neonatal death. Since the publication of A Randomized Trial of Induction Versus Expectant Management (ARRIVE) in 2018, there was an increase in 39 weeks deliveries. The objective of this study was to evaluate the trends in perinatal mortality by BMI category from 2015 to 2020.

A Narrative Review of Congenital Syphilis in the United States: Innovative Perspectives on a Complex Public Health and Medical Disease.

Over the past two decades, congenital syphilis cases have risen 11-fold in the United States. While disparities across geography, race, and ethnicity exist, lack of timely screening or treatment is identified in 88% of cases nationally. Congenital syphilis is a public health and medical problem rooted in systematic and societal structural determinants of health and healthcare limitations.

Qualitative analysis of Doppler assessment used for surveillance of alloimmunized individuals.

Objectives: To summarize image quality variables for alloimmunized women at risk for fetal anemia. To investigate the association between image quality with the highest and median middle cerebral artery peak systolic velocity (MCA-PSV) at the last visit and fetal anemia based on hemoglobin.

Study Design: This study was a qualitative retrospective analysis of 192 Doppler ultrasound images used in the detection of fetal anemia in 26 alloimmunized women seen in a Minneapolis hospital over the past 3 years.

Maternal ADHD and Perinatal Prescription Stimulant Use.

Objective: To describe patterns and predictors of perinatal prescription stimulant use.

Methods: We used MarketScan commercial claims data (2013-2018) and a repeated cross-sectional study design to assess perinatal use of prescription stimulants. Clinical/demographic characteristics were compared across cohorts of women who continued versus discontinued stimulant treatment at various stages of pregnancy.

Impact of labor induction at 39 weeks gestation compared with expectant management on maternal and perinatal morbidity among a cohort of low-risk women.

Objective: To determine maternal and perinatal outcomes after induction of labor (IOL) at 39 weeks compared with expectant management.

Methods: This is a retrospective national cohort study from the National Center for Health Statistics birth database. The study included singleton, low-risk pregnancies with a non-anomalous fetus delivered at 39-42 weeks gestation between 2015 and 2018.

Use of the Renal Artery Doppler to Identify Small for Gestational Age Fetuses at Risk for Adverse Neonatal Outcomes.

Objective: To measure the sensitivity and positive predictive value (PPV) for an adverse neonatal outcome among growth-restricted fetuses (FGR) comparing the cerebral-placental ratio (CPR) with the cerebral-renal ratio (CRR).

Methods: Retrospective analysis of 92 women who underwent prenatal ultrasound at the University of Maryland and the University of Padua. Renal, middle cerebral and umbilical artery Doppler waveforms were recorded for all scans during the third trimester.

Catecholaminergic polymorphic ventricular tachycardia in pregnancy: a case report.

Introduction: Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a genetic disorder that can cause fatal tachyarrhythmias brought on by physical or emotional stress. There is little reported in the literature regarding management of CPVT in pregnancy much less during labor.

Case Presentation: A gravida 2, para 1 presented to our high-risk clinic at 15 weeks gestation with known CPVT.

Outcomes of labor induction at 39 weeks in pregnancies with a prior cesarean delivery.

Background: The optimal timing of induction for those undergoing a trial of labor after cesarean section has not been established. The little data which supports the consideration of induction at 39 weeks gestation excludes those with a history of prior cesarean section.

Objective: To determine the risks and benefits of elective induction of labor (IOL) at 39 weeks compared with expectant management (EM) until 42 weeks in pregnancies complicated by one previous cesarean delivery.

Fetal growth standards for Somali population.

Background: Accurate assessment of fetal size is essential in providing optimal prenatal care. National Institute of Child Health and Human Development (NICHD) study from 2015 demonstrated that estimated fetal weight (EFW) differed significantly by race/ethnicity after 20 weeks. There is a large Somali population residing in Minnesota, many of whom are cared for at our maternal fetal medicine practice at the University of Minnesota.

Fetal exposure to mercury and lead from intrauterine blood transfusions.

Background: Mercury (Hg) and lead (Pb) exposure during childhood is associated with irreversible neurodevelopmental effects. Fetal exposure to Hg and Pb from intrauterine blood transfusion (IUBT) has not been reported.

Methods: Fetal exposure was estimated based on transfusion volume and metal concentration in donor packed red blood cell (PRBCs).

Renal artery Doppler compared with the cerebral placental ratio to identify fetuses at risk for adverse neonatal outcome.

Current clinical practice incorporates an umbilical artery resistance index or a ratio of the middle cerebral artery (MCA PI) to the umbilical artery pulsatility index (UA PI) known as the cerebral placental ratio (CPR) to assess wellbeing in the small for gestational age fetus. Previous reports using the renal artery Doppler indices have not been consistent in regards to their design and clinical use. Our objective is to develop reference values for renal artery Doppler indices and validate their use compared with the UA PI or CPR to identify fetuses that will develop a composite neonatal outcome.

Critical barriers for preeclampsia diagnosis and treatment in low-resource settings: An example from Bolivia.

The goals of the United Nation's Millennium Summit for reducing maternal mortality have proven difficult to achieve. In Bolivia, where maternal mortality is twice the South American average, improving the diagnosis, treatment and ultimately prevention of preeclampsia is key for achieving targeted reductions. We held a workshop in La Paz, Bolivia to review recent revisions in the diagnosis and treatment of preeclampsia, barriers for their implementation, and means for overcoming them.

The role of fetal growth restriction in the association between Down syndrome and perinatal mortality.

Down syndrome (DS) is associated with significant risk of perinatal mortality. We hypothesize that this association is primarily mediated through the effects of fetal growth restriction (FGR). This was a retrospective cohort analysis using the US Natality Database from 2011 to 2013.

Utility of prenatal Doppler ultrasound to predict neonatal impaired cerebral autoregulation.

Objective: Determine if abnormal prenatal Doppler ultrasound indices are predictive of postnatal impaired cerebral autoregulation.

Study Design: Prospective cohort study of 46 subjects, 24-29 weeks' gestation. Utilizing near-infrared spectroscopy and receiver-operating characteristic analysis, impaired cerebral autoregulation was defined as >16.

The impact of maternal body mass index on external cephalic version success.

Objective: The purpose of this study is to determine the association between body mass index (BMI) and success of ECV.

Methods: This is a cross-sectional analysis of singleton live births in the USA from 2010 to 2014 using birth certificate data. Patients were assigned a BMI category according to standard WHO classification.

Adverse perinatal outcomes associated with trial of labor after cesarean section at term in pregnancies complicated by maternal obesity.

Introduction: Obesity is associated with higher risks for intrapartum complications. Therefore, we sought to determine if trial of labor after cesarean section (TOLAC) will lead to higher maternal and neonatal complications compared to repeat cesarean section (RCD).

Methods: This was a retrospective cohort analysis of singleton nonanomalous births between 37 and 42 weeks GA complicated by maternal obesity (body mass index (BMI) ≥ 30 kg/m) and history of one or two previous cesarean deliveries.

Mild fetal cerebral ventriculomegaly: prevalence, characteristics, and utility of ancillary testing in cases presenting to a tertiary referral center.

Objective: Ventriculomegaly is the most common fetal brain anomaly identified during prenatal anatomy ultrasound. The aim of our study was to characterize cases of mild ventriculomegaly and investigate the utility of ancillary tests.

Method: We reviewed 121 cases of mild ventriculomegaly, defined as lateral ventricle diameter of 10 to 15 mm.

Association of Maternal Obesity With Maternal and Neonatal Outcomes in Cases of Uterine Rupture.

Objective: To describe the risk of adverse outcomes associated with uterine rupture in the setting of maternal obesity.

Methods: This was a retrospective cohort analysis of singleton nonanomalous neonates born after uterine rupture between 34 and 42 weeks of gestation. We derived data from the U.

Reference Values for Sonographically Estimated Fetal Weight in Twin Gestations Stratified by Chorionicity: A Single Center Study.

Objectives: To determine reference values for sonography-based estimated fetal weight (EFW) in twin gestations in one single tertiary medical center in the United States.

Methods: A retrospective longitudinal analysis of EFW evaluations of fetuses of twin gestations between November 2006 and June 2016. Fetuses with major congenital anomalies or chromosomal abnormalities were excluded.

Third trimester perinatal mortality associated with immediate delivery versus expectant management according to birthweight category.

Objective: Immediate delivery compared with expectant management in a low risk population stratified by birthweight.

Methods: Retrospective cohort of births, stillbirths and neonatal deaths from 2010 through 2012 compiled by the National Center for Health Statistics. Birthweight categories were created using population derived deciles.