Assessing Second Trimester Ferning in Diagnosing Preterm Prelabor Rupture of Membranes.

Preterm prelabor rupture of membranes (PPROM) diagnosis is made through visualization of amniotic fluid (pooling), nitrizine testing, sonographic low amniotic fluid, and microscopic detection of amniotic fluid arborization (ferning). Data exits on the specificity and sensitivity of ferning detection but has not focused on the second trimester. Our objective is to evaluate the presence of ferning in transvaginally collected amniotic fluid in pregnancies with known second trimester PPROM to determine if there is a difference in ferning based on gestational age and sample drying time.

PPROM in the late preterm period: an argument for expectant management.

Preterm prelabor rupture of membranes (PPROM) is associated with significant neonatal risks. When PPROM occurs during the late preterm period (between 34 0/7 and 36 6/7 weeks gestation), the optimal gestational age for delivery is unclear and varies by regional practice. In 2020 the American College of Obstetrician and Gynecologists (ACOG) published guidelines indicating that both expectant management and immediate delivery were considered reasonable options.

The Birth and Beyond (BABY) study: protocol for a birth cohort study investigating the social and environmental determinants of pregnancy-related outcomes in Black American families.

Introduction: In the USA, Black birthing people and infants experience disproportionately worse pregnancy-related health outcomes. The causes for these disparities are unknown, but evidence suggests that they are likely socially and environmentally based. Efforts to identify the determinants of these racial disparities are urgently needed to elucidate the highest priority targets for intervention.

Evaluating the Association between Prenatal Care Visits and Adverse Perinatal Outcome in Pregnancies Complicated by Opioid Use Disorder.

Objective: This study aimed to evaluate the association between number of prenatal care visits and adverse perinatal outcome among pregnant individuals with opioid use disorder (OUD).

Study Design: This is a retrospective cohort of singleton, nonanomalous pregnancies complicated by OUD that delivered from January 2015 to July 2020 at our academic medical center. Primary outcome was the presence of composite adverse perinatal outcome, defined as one or more of the following: stillbirth, placental abruption, perinatal death, neonatal respiratory distress syndrome, need for morphine treatment, and hyperbilirubinemia.

Implementing American College of Obstetricians and Gynecologists Outpatient Antepartum Testing Recommendations: Can Your Clinic Handle It?

Objective: This study was conducted to determine the difference in the number of pregnancies that would qualify for outpatient fetal testing between our current academic practice and that of the 2021 American College of Obstetricians and Gynecologists (ACOG) antepartum recommendations.

Study Design: We performed a retrospective study of all pregnancies that delivered and received prenatal care at our institution between January 1, 2019, and May 31, 2021. The timing and amount of outpatient antepartum testing was determined for each patient.

Impact of obesity on blood pressures measured at alternative locations during pregnancy.

Background: In patients with obesity, the distribution of subcutaneous tissue can make blood pressure measurement on the standard location of the upper arm difficult. In these cases, alternative locations, such as the lower arm or wrist, are commonly used. It is unknown whether there is a discrepancy in these measurements for pregnant patients at extremes of body mass index.

Risk factors for needing postpartum antihypertensive medications with hypertensive disorders: Timing of diagnosis, presence of proteinuria, and severity of disease.

Objectives: Evaluate the association between the need for post-partum antihypertensive medications in patients with hypertensive disorders of pregnancy (HDP) and the following: timing of disease onset (antepartum vs. intrapartum), presence of proteinuria, and severity of disease.

Study Design: This was a retrospective cohort study.

Preterm prelabor rupture of membranes: evaluating latency and neonatal morbidity for pregnancies with expectant management ≥34 weeks.

Objective: To evaluate the association between latency and neonatal morbidity for pregnancies with expectant management of PPROM ≥34 w.

Materials And Methods: A retrospective cohort of singletons with PPROM from 2011 to 2016. Exposure was defined as latency (period from diagnosis of PPROM to delivery) and was analyzed as a count variable (i.

Stillbirth in women with diabetes: a retrospective analysis of fetal autopsy reports.

Introduction: Diabetes in pregnancy is associated with an increased rate of stillbirth. There are a wide variety of factors that have been implicated including placental insufficiency, hypoxia, hyperinsulinemia and impaired cardiac function. Furthermore, there is evidence that diabetic pregnancies have an increased rate of fetal cardiomyopathy as compared to non-diabetic pregnancies.

Impact of Maternal Obesity on Perinatal Outcomes in Preterm Prelabor Rupture of Membranes ≥34 Weeks.

Objective: This study aimed to compare pregnancy outcomes in obese and nonobese women with preterm prelabor rupture of membranes (PPROM) ≥34 weeks.

Study Design: The present study is a secondary analysis of a multicenter retrospective cohort of singletons with PPROM from 2011 to 2017. Women with a delivery body mass index (BMI) ≥30 kg/m (obese) were compared with women with a BMI < 30 kg/m (nonobese).

Second trimester uterocervical angle and spontaneous preterm birth in twins.

To determine if there is an association between uterocervical angle (UCA) and spontaneous preterm birth (sPTB) < 37 weeks for women with twins. Retrospective cohort study from 2014 to 2017 of twin pregnancies with cervical length (CL) screening between 15 0/7 and 24 6/7 weeks. Monochorionic-monoamniotic twins were excluded.

Temporal Themes in Periviable Birth: A Qualitative Analysis of Patient Experiences.

Objective Periviable birth accounts for a very small percentage of preterm deliveries but a large proportion of perinatal and neonatal morbidity. Understanding parental experiences during and after periviable deliveries may help healthcare providers determine how to best support women during these medically complex, emotionally charged clinical encounters. Methods This is a qualitative study with a voluntary sample of women who delivered between 22 and 25 weeks gestation at an academic medical center from 2014 to 2016.

Preterm Prelabor Rupture of Membranes: Outcomes with Expectant Management until 34 versus 35 Weeks.

Objective: To evaluate outcomes with expectant management of preterm prelabor rupture of membranes (PROM) until 35 weeks versus immediate delivery at ≥34 weeks.

Study Design: This was a multicenter retrospective cohort study of singletons with preterm PROM at >20 weeks from 2011 through 2017. Groups were defined as expectant management until 35 weeks versus immediate delivery at ≥34 weeks.

Prenatal Prediction of Difficult Intubation in Periviable Neonates Using Standard Fetal Biometric Parameters.

Objective: To assess whether standard fetal biometric parameters can be used to predict difficult intubations in periviable neonates undergoing resuscitation.

Study Design: This is a retrospective case-control study of periviable neonates delivered at 23 to 25 weeks at an academic hospital during a 5-year period in whom intubation was attempted. Standard fetal biometric measurements were included if they were taken within 7 days of delivery.

Alcoholic Pancreatitis Masquerading as Preeclampsia.

Background: Coexisting medical complications in pregnancy can present in a fashion similar to preeclampsia and can be challenging to differentiate.

Case: We present a patient who, at 27 3/7 weeks of gestation, fulfilled diagnostic criteria for severe preeclampsia, including hypertension, proteinuria, headache, abnormal serum creatinine levels, thrombocytopenia, and liver function abnormalities, but who nevertheless did not have preeclampsia. Instead, she was diagnosed with alcoholic pancreatitis based on a history of heavy alcohol use and elevated amylase and lipase.

HOXA11 promotes fibroblast proliferation and regulates p53 in uterosacral ligaments.

The uterosacral ligaments (USLs) are key support structures of the uterus and upper vagina. Previously, we have shown that HOXA11 is necessary for the development of the USLs, is deficient in women with pelvic organ prolapse (POP) and regulates expression of extracellular matrix (ECM) proteins. Here we sought to determine if HOXA11 regulates cell proliferation in the USLs in women.