Why Equitable Access to Vaginal Birth Requires Abolition of Race-Based Medicine.

In 2010, the National Institute of Child Health and Human Development Maternal-Fetal Medicine Units (MFMU) Network developed a decision aid, the Vaginal Birth After Cesarean (VBAC) calculator, to help clinicians discern how one variable (race) might influence patients' success in delivering a baby vaginally following a prior birth by cesarean. The higher rate of cesarean deliveries among Black and Hispanic women in the United States has long demonstrated racial inequities in obstetrical care, however. Although the MFMU's new VBAC calculator no longer includes race or ethnicity, in response to calls for abolition of race-based medicine, this article argues that VBAC calculator use has never been race neutral.

Why Professionalism Demands Abolition of Carceral Approaches to Patients' Nonadherence Behaviors.

Some clinicians' and organizations' considerations of how a patient's prior adherence to health recommendations should influence that patient's candidacy for a current intervention express structural racism and carceral bias. When clinical judgment is influenced by racism and carceral logic, patients of color are at risk of having their health services delivered by clinicians in ways that are inappropriately interrogative, aggressive, or punitive. This commentary on a case suggests how an abolitionist approach can help clinicians orient themselves affectively to patients whose health behaviors express or have expressed nonadherence.

Prolonged second stage of labor and risk of subsequent spontaneous preterm birth.

Background: Preterm birth is the leading cause of neonatal morbidity and death in the United States. Although many risk factors for spontaneous preterm birth have been elucidated, some women with a previous term delivery experience spontaneous preterm birth in the absence of any identifiable risk factors. Cervical trauma during a prolonged second stage of labor has been postulated as a potential contributor to subsequent spontaneous preterm birth.

Linking Global Health to Local Health within an Ob/Gyn Residency Program.

An unprecedented number of medical students and residents express the desire to participate in global health work during their training and beyond. Preparing learners for work in underserved settings makes it more likely that they will continue to work in areas of need. Training programs that focus on global health have been criticized as there is ample work to be done in the US, and often global health work becomes learner-centric, which is difficult to maintain and potentially burdensome and harmful to the host site.

What Is New in the Prevention of Preeclampsia?: Best Articles From the Past Year.

This month we focus on current research in prevention of preeclampsia. Dr. Norton discusses five recent publications, which are concluded with a "bottom line" that is the take-home message.

Vasal injury during inguinal herniorrhaphy: a case report and review of the literature.

An injury to the vas deferens during inguinal herniorrhaphy from possible tethering of the vas has not, to our knowledge, previously been described in the surgical literature. We report a case of iatrogenic injury of the vas deferens that occurred during elective hernia repair in a 28-year-old man who had previously sustained blunt trauma to the abdomen and pelvis.

Cdc25A activity is required for the metaphase II arrest in mouse oocytes.

Mammalian oocytes are arrested in metaphase of second meiosis (MII) until fertilization. This arrest is enforced by the cytostatic factor (CSF), which maintains the M-phase promoting factor (MPF) in a highly active state. Although the continuous synthesis and degradation of cyclin B to maintain the CSF-mediated MII arrest is well established, it is unknown whether cyclin-dependent kinase 1 (Cdk1) phosphorylations are involved in this arrest in mouse oocytes.

Innovations in Pap Screening for Cervical Neoplasia.

The Papanicolaou (Pap) smear has been credited with reducing deaths from cervical cancer over recent decades. Retrospective studies have shown that 49% to 72% of patients with cervical cancer had not been screened or had been improperly screened, but 30% to 50% of women with cervical cancer had had a normal smear within the past 3-4 years. About 25% of the estimated 8000 false-negative Paps a year are potentially preventable by refinement of Pap readings and an additional 25% by improvement in the sampling technique/process.