Increasing Access to Abortion: ACOG Committee Statement No. 16.

Legal and accessible abortion care is a necessary component of comprehensive health care. Access to abortion is threatened by local, state, and federal government restrictions; limitations on insurance coverage of abortion care; restrictions on funding for training; restrictions imposed by hospitals and health care systems; stigma; violence against health care professionals who provide abortion care; and a subsequent dearth of health care professionals who provide this care. Since the Dobbs v.

Comparison of Three Chimeric Zika Vaccine Prototypes Developed on the Genetic Background of the Clinically Proven Live-Attenuated Japanese Encephalitis Vaccine SA-14-2.

Zika virus (ZIKV) is a medically important mosquito-borne orthoflavivirus, but no vaccines are currently available to prevent ZIKV-associated disease. In this study, we compared three recombinant chimeric viruses developed as candidate vaccine prototypes (rJEV/ZIKV, rJEV/ZIKV, and rJEV/ZIKV), in which the two neutralizing antibody-inducing prM and E genes from each of three genetically distinct ZIKV strains were used to replace the corresponding genes of the clinically proven live-attenuated Japanese encephalitis virus vaccine SA-14-2 (rJEV). In WHO-certified Vero cells (a cell line suitable for vaccine production), rJEV/ZIKV exhibited the slowest viral growth, formed the smallest plaques, and displayed a unique protein expression profile with the highest ratio of prM to cleaved M when compared to the other two chimeric viruses, rJEV/ZIKV and rJEV/ZIKV, as well as their vector, rJEV.

Prevention of Maternal Rh D Alloimmunization: A Comparative Review of Guidelines.

Importance: Rhesus alloimmunization refers to the sensitization of an Rh D-negative mother after exposure to D-positive fetal red blood cells, which can lead to significant fetal and neonatal morbidity and mortality.

Objective: The aim of this study was to review and compare the most recently published international guidelines on the prevention of maternal alloimmunization.

Evidence Acquisition: A comparative review of guidelines from the American College of Obstetricians and Gynecologists, the British Committee for Standards in Hematology, the International Federation of Gynecology and Obstetrics, the Royal Australian and New Zealand College of Obstetricians and Gynecologists, and the Society of Obstetricians and Gynecologists of Canada regarding the prevention of maternal Rh D alloimmunization was conducted.

A New Way Forward for Women's Health Research at the National Institutes of Health: A Roadmap From the National Academies of Sciences, Engineering, and Medicine's Consensus Report.

Despite efforts to address inequities, research on women's health conditions (defined as those that uniquely or differently affect women and female individuals) remain significantly understudied. As directed by Congress, the National Institutes of Health (NIH) Office of Research on Women's Health requested the National Academies of Sciences, Engineering, and Medicine (National Academies) to conduct an assessment of the state of women's health research at the NIH. The findings of the National Academies committee include: 1) a significant funding inequity, with less than 8% of the total NIH grant budget for fiscal year 2023 allocated to women's health research; 2) a need for improved strategic NIH-wide priority setting, oversight, and adherence to existing policies to support women's health research; 3) a need for a specific institute for research on conditions specific to women's health; and 4) a need for sufficient training and additional funding to grow and retain the women's health research workforce.

Rho(D) immune globulin shortage and fetal Rh(D) screening with cell-free DNA.

Purpose Of Review: Despite the availability of Rh(D) immune globulin (RhIg) to prevent alloimmunization in Rh(D)-negative pregnant patients, anti-Rh(D) alloimmunization remains a prevalent cause of hemolytic disease of the fetus and newborn (HDFN). Recent RhIg shortages have caused clinicians and professional societies to identify methods to prioritize RhIg administration. New cell-free DNA (cfDNA) tests to predict fetal red blood cell antigen genotypes have been proposed as an option to prioritize the administration of RhIg to Rh(D)-negative pregnant people.

A Cohort Study Exploring HPV Vaccination Beliefs Among Oral Health Providers: Broadening the Scope of Education and Administration.

Background/objectives: There is potential utility and increasing interest in engaging professionals in non-traditional vaccination settings to participate in efforts to reduce human papillomavirus (HPV)-related cancer. This study assessed the impact of a multi-disciplinary HPV educational intervention on oral health care professionals' perceived role, comfort level, and scope of practice in HPV-related cancer prevention efforts.

Methods: The virtual educational intervention was provided by a multi-disciplinary panel of experts.

Improving the Health and Environmental Health Literacy of Professionals: Evaluating the Effect of a Virtual Intervention on Phthalate Environmental Health Literacy.

The American College of Obstetricians and Gynecologists provided updated guidance in 2021, recommending that reproductive health professionals should include discussion of environmental exposures with their patients. However, environmental health is seldom included in medical training, with endocrine-disrupting chemicals, such as phthalates-linked to adverse pregnancy outcomes-being among the least discussed. We developed a one-hour virtual educational intervention to train reproductive health professionals on the routes of phthalate exposure, potential associated health impacts, and suggestions on how to discuss exposure reduction with patients.

Emergency department use during pregnancy by Medicaid type.

Background: Emergency department (ED) use is common among patients with Medicaid insurance during pregnancy. However, it is unknown how ED utilization differs among those with different types of Medicaid such as Emergency Medicaid, with which access to outpatient care is more restricted.

Objective: We sought to compare differences in ED use during between pregnant persons with Emergency Medicaid and Traditional Medicaid and pregnancy outcomes by ED utilization.

Pneumonia Vaccines: Indications for Use and Current Safety Data in Pregnancy.

is a leading cause of pneumonia, meningitis, and invasive pneumococcal disease among adults in the United States, with higher rates of disease occurring among individuals with chronic medical and immunocompromising conditions. Pregnant individuals, especially those with comorbid conditions, are also at increased risk of infection due to due to physiological and immunologic changes in pregnancy. Vaccination against pneumococcus is recommended for adults living with HIV aged 19 to 49, congenital or acquired immunodeficiency, asplenia, chronic renal failure, sickle cell disease, alcohol abuse, cerebrospinal fluid leaks, congestive heart failure and cardiomyopathies, chronic lung disease, chronic liver disease, and diabetes mellitus.

Obstetric-specific compared to general early warning system for predicting severe postpartum maternal morbidity.

Severe maternal morbidity is a major global health concern, and early identification of at-risk postpartum women is essential to improving outcomes. We aimed to compare the predictive values of the Modified Early Obstetric Warning System (MEOWS) versus the non-obstetric general Early Warning System (EWS) for predicting severe maternal morbidity in postpartum women. We retrospectively reviewed hospital documentation of 723 postpartum women admitted to the obstetric high dependency unit between October 2020 and March 2021.

Shortcomings of ethnicity-based carrier screening for conditions associated with Ashkenazi Jewish ancestry.

Purpose: Carrier screening identifies reproductive risk for autosomal recessive and X-linked genetic conditions. Currently, some medical society guidelines continue to recommend ethnicity-based carrier screening for conditions associated with Ashkenazi Jewish (AJ) ancestry. We assessed the utility and limitations of these guidelines in a large, ethnically and genetically diverse cohort of genotyped individuals.

Supporting Labor After 2 Cesarean Births.

Labor after cesarean (LAC) is a safe alternative for pregnant persons who have had 1 or 2 previous cesarean births (CBs) and have no contraindication to vaginal birth. When compared with repeat CB, vaginal birth after cesarean (VBAC) reduces short- and long-term health complications and morbidity and should therefore be presented as an option. Despite recommendations from the American College of Nurse-Midwives and the American College of Obstetricians and Gynecologists in support of LAC, not all pregnant persons who are candidates have access to this option.

Brain and brain blood vessels histological description in autopsies of fetuses/neonates born to mothers with hypertension during pregnancy. A case-control study.

Background: Children born to women with hypertension during pregnancy have a two to threefold increased risk of developing cognitive disorders compared to children born to women without hypertension. However, structural changes in the central nervous system of these children remain poorly understood. We aim to compare the brain histological findings from autopsies of neonates and fetuses born to women with and without hypertension during pregnancy.

Harm reduction for perinatal cannabis use: protocol for a scoping review of clinical practices.

Introduction: The American College of Obstetricians and Gynaecologists recommends against cannabis use during pregnancy and lactation ('perinatal cannabis use') given its association with negative parent-child health outcomes. However, cannabis is becoming increasingly available and used during pregnancy, and perceptions of safety are correspondingly increasing. For individuals who are unable or unwilling to cease use during pregnancy and lactation, harm reduction is the best available evidence-based practice to promote health.

Vaginal progesterone for prevention of preterm birth in women with a history of preterm birth regardless of cervical length: an argument for use.

It is well understood that preterm birth accounts for a substantial amount of poor neonatal outcomes. In 2022, preterm birth affected about 1 of every 10 infants born in the United States with complications ranging from mild respiratory distress syndrome to neonatal death. The complexity of the treatment is secondary to the fact that preterm birth is a multifactorial syndrome with intricate sociocultural factors that influence our racially disproportionate poor outcomes.

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.

Pilates exercises during pregnancy: A narrative review.

Background: The Pilates method has various health benefits, including reducing kinesiophobia, alleviating pain intensity, and improving disability among individuals with low back pain. Additionally, it has been shown to positively impact mental health outcomes such as depression, anxiety, and fatigue. However, the safety and efficacy of practicing Pilates during pregnancy have not been clearly established.

Innovations in Diabetes Management for Pregnant Women: Artificial Intelligence and the Internet of Medical Things.

Pregnancies impacted by diabetes face the compounded challenge of strict glycemic control with mounting insulin resistance as the pregnancy progresses. New technological advances, including artificial intelligence (AI) and the Internet of Medical Things (IoMT), are revolutionizing health care delivery by providing innovative solutions for diabetes care during pregnancy. Together, AI and the IoMT are a multibillion-dollar industry that integrates advanced medical devices and sensors into a connected network that enables continuous monitoring of glucose levels.