The impact of uterine position on conception modes and perinatal outcomes in nulliparous patients.

Purpose: Retroverted uterus affects 15-20% of patients. While typically not a cause for concern, some studies suggest a relationship between a retroverted uterus and subfertility. Study objective was to investigate the association between uterine position and spontaneous conception rates, as well as potential risks for adverse pregnancy outcomes in nulliparous patients.

Interpregnancy interval following missed abortion and the risk for preterm birth.

Objective: Short inter-pregnancy interval (IPI) of <18 months following a live birth, has been associated with adverse pregnancy outcome. This study aimed to evaluate whether a short IPI following a medically treated missed abortion (MA) poses similar perinatal risks in a subsequent pregnancy.

Study Design: The retrospective analysis included patients with history of an MA at up to 10 weeks of gestation, treated with misoprostol (pgE1) only, and with a documented subsequent live pregnancy (2010-2022).

Interpregnancy interval after vacuum delivery and subsequent perinatal outcomes.

Objective: To evaluate whether a short interpregnancy interval (IPI) after vacuum extraction (VE), poses similar perinatal risks in a subsequent pregnancy.

Methods: This was a retrospective, single-center cohort study between 2011 and 2021. Nulliparous women with term, singleton VE deliveries and with known pregnancy outcomes in their subsequent pregnancy were eligible for inclusion in the study.

Delivery mode after cervical ripening among patients with no prior vaginal births.

Purpose: To compare mode of delivery and maternal and neonatal outcomes using cervical ripening balloon (CRB) for induction of labor (IOL) in nulliparous patients vs. those undergoing first trial of labor after cesarean (TOLAC).

Methods: Retrospective cohort study including data from two tertiary medical centers.

Fixed-time interval vs on-demand oral analgesia after vaginal delivery: a randomized controlled trial.

Background: Scheduled administration of analgesics was proven superior to on-demand dosing following cesarean deliveries. However, this protocol was not compared after vaginal delivery.

Objective: To compare the efficacy of a fixed- vs on-demand analgesic protocol for the management of pain in the first 24 hours after a vaginal delivery.

Exploring the Optimal Intertwin Delivery Interval for Vaginal Delivery.

The effect of prolonged intertwin delivery interval (IDI) is not well studied. This work aimed to assess the inflection point for Cesarean delivery (CD) and associated adverse maternal and neonatal outcomes. This was a retrospective cohort study at a single tertiary care center.

The optimal cutoff for intertwin delivery interval: A retrospective cohort study.

Objective: To determine the cutoff of intertwin delivery intervals (IDIs) as a predictor for neonatal acidemia.

Method: This retrospective cohort study was conducted at a single tertiary care center. Women attempting vaginal delivery of twins between 2010 and 2019 and who reached the second stage of labor were included.

Does delayed vacuum-assisted delivery harbor greater maternal or neonatal complications?

Objective: To compare maternal and fetal outcomes between early (<2 h) and delayed (>2 h) vacuum extraction (VE) deliveries.

Methods: We performed a retrospective cohort study in a single, university-affiliated medical center (2014-2021). We included term singleton pregnancies delivered by VE, allocated into one of two groups according to second stage duration: <2 h or >2 h.

The effect of oral probiotics on glycemic control of women with gestational diabetes mellitus-a multicenter, randomized, double-blind, placebo-controlled trial.

Background: Gestational diabetes mellitus should be treated adequately to avoid maternal hyperglycemia-related complications. Previously, probiotic supplements were suggested to improve fasting blood glucose in women with gestational diabetes mellitus. However, a major limitation of previous studies was that preprandial and especially postprandial glucose values, which are important predictors of pregnancy outcomes, were not studied.

Pre-labour Rupture of Membranes at Term in Women With Gestational Diabetes and the Risk of Neonatal Hypoglycemia.

Objectives: The management for improving maternal and neonatal outcomes of women with gestational diabetes mellitus (GDM) arriving at the delivery ward with pre-labour rupture of membranes (PROM) has not been elucidated. We tested the hypothesis that prolonged PROM in women with GDM would result in higher rates of neonatal hypoglycemia.

Methods: We retrospectively enrolled women with diet or insulin-controlled GDM who presented with spontaneous clear PROM.

Continuous vs intermittent induction of labor with oxytocin in nulliparous patients: a randomized controlled trial.

Background: Oxytocin is considered the drug of choice for the induction of labor, although the optimal protocol and infusion duration remain to be determined.

Objective: This study aimed to assess whether the duration of oxytocin infusion increases 24-hour delivery rates and affects the length of time-to-delivery and patient's experience.

Study Design: A randomized controlled trial was performed at a single tertiary medical center, between January 1, 2020 and June 30, 2022.

Risk Factors for Prolonged Intertwin Delivery Interval and Associated Maternal and Second Twin Morbidity.

Objective: This work aimed to identify possible risk factors and the morbidity associated with prolonged intertwin delivery interval (IDI).

Study Design: A retrospective cohort study at a single tertiary care center. Women with twin gestations who reached the second stage of labor between January 2010 and December 2019 were included in the study.

Intermittent vs continuous catheterization for postpartum urinary retention: A multicenter randomized controlled trial.

Background: Postpartum urinary retention is a common complication in the immediate postpartum period. However, there is no consensus regarding optimal management.

Objective: This study aimed to compare 2 catheterization strategies for the treatment of postpartum urinary retention.

The impact of extending the second stage of labor on repeat cesarean section and maternal and neonatal outcome.

Objective: To evaluate the effects of extending the second stage of labor in women attempting a trial of labor after a cesarean section (TOLAC).

Method: A retrospective cohort study comparing maternal and neonatal outcomes following TOLAC over two periods: period I whose prolonged second stage was considered 2 h, and period II whose prolonged second stage was considered 3 h. The primary outcome was repeat cesarean delivery (CD) rate.

Late preterm delivery has a distinctive second-stage duration and characteristics.

Background: Late preterm neonates born between 34.0 and 36.6 weeks' gestation are at increased risk for short- and long-term morbidity and mortality when compared with their term counterparts.

Which part of cervical length is predictive of preterm birth in women with cerclage?

Objective: To evaluate the predictive value of transvaginal ultrasonography measures: total cervical length (TCL), length to internal OS (LIO) and external OS (LEO) from the cerclage following cerclage placement, for spontaneous preterm birth (PTB).

Methods: A retrospective cohort at a single tertiary care center (2010-2020). Women with McDonald cerclage were evaluated during the 2nd and 3rd trimesters for cervical measurements: TCL, LIO, LEO.

Magnesium sulphate neuroprotection mechanism is placental mediated by inhibition of inflammation, apoptosis and oxidative stress.

Introduction: Maternal inflammation may induce placental cytokine production resulting in fetal exposure, and development of neonatal neurologic injury. Maternal magnesium sulphate (MG) is used as neuroprotective in preventing white matter brain injury. We sought to determine whether maternal MG can prevent placental activation of inflammatory pathways associated with fetal injury.

A randomized controlled trial of 2 techniques of salpingectomy during cesarean delivery.

Background: Total salpingectomy during benign gynecologic surgery is recommended after completion of childbearing to reduce the risk of developing ovarian cancer.

Objective: This study aimed to assess operating time and complication rates of "traditional" salpingectomy using the "Knot and Cut" technique, compared with bipolar salpingectomy for sterilization at the time of cesarean delivery.

Study Design: This was a randomized controlled trial.

Continuous versus disrupted subcutaneous tissue closure in cesarean section: A retrospective cohort study.

Objectives: To compare rates of surgical-site infections following continuous, as compared with interrupted, subcutaneous tissue closure technique during cesarean delivery (CD).

Methods: A retrospective cohort study during 2008-2018. The study group included women who underwent either elective or emergent CD with continuous subcutaneous tissue closure, while the control group comprised those with interrupted subcutaneous tissue closure.

Vaginal fluid index - The fifth amniotic pocket.

Objective: The forebag is a pocket of amniotic fluid preceding the fetal presenting part. Herein we describe the feasibility of transvaginal measurements of the forebag and assess its correlation with the standard amniotic fluid index (AFI).

Methods: A prospective study was carried out between January 2019 and July 2020.

Vaginal Dinoprostone Insert versus Cervical Ripening Balloon for Term Induction of Labor in Obese Nulliparas-A Randomized Controlled Trial.

Data regarding the preferred induction method in women with obesity is scarce. The current study was aimed at comparing pharmacological and mechanical induction in this population. This prospective randomized controlled trial was conducted between 2016−2020, in nulliparas with a pre-pregnancy body mass index >30.

Is there a benefit of antenatal corticosteroid when given < 48 h before delivery?

Objective: We assessed the association between a short antenatal corticosteroid administration-to-birth interval and neonatal outcome.

Study Design: A retrospective study was conducted between 2010 and 2020. Eligible cases were singleton preterm live-born neonates born between 24-0/7 and 33-6/7 weeks of gestation and were initiated an ACS course of betamethasone.

Cervical ripening with multiple medical or combined induction methods: Risks of subsequent preterm birth in nulliparous women.

Objective: To determine the impact of combined medical and medical/mechanical methods for cervical ripening on the risk of preterm birth in subsequent pregnancy, in nulliparous women.

Methods: A retrospective cohort study of nulliparous women with term singleton gestations induced by single or combined methods at one center who had their subsequent second birth in the same center. Study groups were compared with a control group of nulliparous women not induced.

Higher risk of hemorrhage and maternal morbidity in vaginal birth after second stage of labor C-section.

Purpose: This study evaluated the association between timing and indication for previous cesarean section (C-section) and its association with postpartum risks for adverse maternal outcomes, primarily postpartum hemorrhage (PPH) in vaginal birth after cesarean (VBAC).

Methods: This retrospective case-control study examined women following term vaginal delivery in a university-affiliated medical center between 2008 and 2018. Postpartum complications were compared between women who had their first VBAC and a control group comprised of women who had vaginal delivery without prior C-section.

Optimizing cervical ripening in women presenting with decreased fetal movements.

Objective: To determine the optimal method for cervical ripening in women presenting with decreased fetal movements at term. We hypothesized that women who undergo induction of labor for decreased fetal movements represent a higher risk group, and will benefit from mechanical intervention with cervical ripening balloon rather than with pharmacological prostaglandin E2 vaginal insert.

Study Design: Retrospective cohort study from January 2014 and January 2019.