American Journal of Obstetrics and Gynecology

The routine use of surgical safety checklists can reduce perioperative complications. Generic surgical checklists are insufficient for cesarean delivery because each cesarean delivery involves two patients (mother and fetus/newborn), each with separate care teams and health and safety considerations. To address the added complexity of care coordination and communication inherent in cesarean delivery, the Society for Maternal-Fetal Medicine presents example standard surgical safety checklists for cesarean surgery that include elements of care for both the mother and newborn...

OBJECTIVE: To examine the relationship between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy and the risk of preeclampsia. DATA SOURCES: MEDLINE, EMBASE, POPLINE, CINAHL, LILACS, and WHO COVID-19, Chinese, and preprint databases (all from December 1, 2019 to May 31, 2021). Google Scholar, bibliographies, and conference proceedings were also searched. STUDY ELIGIBILITY CRITERIA: Observational studies that assessed the association between SARS-CoV-2 infection during pregnancy and preeclampsia and that reported unadjusted and/or adjusted risk estimates and 95% confidence intervals (CIs) or data to calculate them...

No abstract text is available yet for this article.

BACKGROUND: The urogenital microbiome is associated with urgency and mixed urinary incontinence symptoms and differential treatment response to pharmacotherapy for urgency urinary incontinence. OBJECTIVE: To describe whether the preoperative urinary and vaginal microbiomes were associated with treatment response 12-months after mid-urethral sling surgery in women with mixed urinary incontinence. STUDY DESIGN: This cohort study compared the preoperative microbiome compositions of urine and vaginal samples from a subset of women undergoing mid-urethral sling surgery in the ESTEEM (Effects of Surgical Treatment Enhanced with Exercise for Mixed Urinary Incontinence) trial (NCT01959347) and compared the microbiota in women who were surgical responders versus surgical non-responders...

BACKGROUND: Antenatal depression affects approximately one in seven pregnancies, with an increasing prevalence across gestation. Data regarding the associations between antenatal depression and adverse pregnancy outcomes yield conflicting results. However, previous studies evaluated the cross-sectional prevalence of depression at various time points, and not the trajectory of depressive symptoms across gestation. OBJECTIVE: To identify whether the trajectory of antenatal depressive symptoms is associated with different risks of adverse pregnancy outcomes...

BACKGROUND: Risk of a high-grade lesion in women undergoing colposcopy following an abnormal screening result may be different by human papillomavirus (HPV) vaccination status, since vaccinated women are presumably less likely to harbor HPV 16 and 18. OBJECTIVE: We evaluated whether the risk of high-grade cervical lesion diagnosed through colposcopy is lower in women vaccinated for HPV compared with unvaccinated women referred to colposcopy based on equal abnormal screening findings...

OBJECTIVE: Accurate pre-operative counseling regarding whether endometriotic cystectomy has a detrimental effect on the ovarian reserve has been a considerable challenge, as studies assessing antral follicle counts (AFC) and anti-Müllerian hormone (AMH) levels have reported conflicting results. Our objective was to explore the impact of endometriotic cystectomy on both AMH and AFC measurements, but focusing on prospective studies where both were measured for each woman concurrently (overcoming unmeasured confounding), in the same setting (overcoming surgical technique differences) and at the same three postoperative time points; early (one to six weeks), intermediate (two to six months) and late (nine to eighteen months), to overcome time-sensitive changes...

No abstract text is available yet for this article.

BACKGROUND: Current consensus recommendations are to not initiate cervical cancer screening for immunocompetent adolescent females prior to age 21 years. This is in part due to very low rate of 0.8 per 100,000 new cervical cancer cases diagnosed among women ages 20 to 24 years. Timely HPV vaccination further decreases incidence of cervical cancer to 4 cases per 100,000 persons by the age of 28 years. Screening prior to age 21 has demonstrated no clear benefit in cancer risk reduction or outcomes...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND: An increased incidence of monozygotic twinning following blastocyst transfer has been previously reported in assisted reproductive technology treatment. It is uncertain whether this phenomenon is due to the extended culture time, culture medium, or inherent blastocyst parameters. OBJECTIVE: To investigate the association between blastocyst parameters (in vitro culture time, blastocyst stage, inner cell mass and trophectoderm grading) and the incidence of monozygotic twinning after assisted reproductive technology...

BACKGROUND: The onset of term human parturition involves myometrial gene expression changes to transform the uterus from a quiescent to a contractile phenotype. It is uncertain whether the same changes occur in the uterus during preterm labor. OBJECTIVE: (s): To compare myometrial gene expression between term and preterm labor and determine if the presence of acute clinical chorioamnionitis or twin gestation affects these signatures. STUDY DESIGN: Myometrium was collected at cesarean section from 7 different groups of patients: term not-in-labor (TNIL, n=31), term labor (TL, n=13), preterm not-in-labor (PTNIL, n=21), preterm labor with acute clinical chorioamnionitis (PTL-C, n=6), preterm labor with no acute clinical chorioamnionitis (PTL-NC, n=9), twin preterm not-in-labor (TWIN-PTNIL, n=8) and twin preterm labor with no acute clinical chorioamnionitis (TWIN-PTL-NC, n=5)...

BACKGROUND: Multidisciplinary care for placenta accreta spectrum (PAS) improves pregnancy outcomes, but the specific components of such multidisciplinary collaboration varies between institutions. As experience with PAS increases, assessing new surgical techniques and protocols is crucial to help improve maternal outcomes and to advocate for hospital resources. OBJECTIVE: To assess a novel multidisciplinary protocol for the treatment of PAS that involves cesarean delivery, multivessel uterine embolization (MVE), and hysterectomy as a single procedure within a hybrid operative suite...

BACKGROUND: Urinary incontinence is prevalent among women, and it has a significant economic impact. Mixed urinary incontinence, with both stress and urgency urinary incontinence, has a greater adverse impact on quality of life and is more complex to treat compared to either stress or urgency urinary incontinence alone. Studies evaluating the cost-effectiveness of treating both the stress and urgency components simultaneously are lacking. OBJECTIVES: Cost effectiveness was assessed between perioperative behavioral and pelvic floor muscle therapy combined with midurethral sling surgery versus surgery alone for the treatment of women with mixed urinary incontinence...

No abstract text is available yet for this article.

The 2021 Women's Preventive Services Initiative (WPSI) Well Woman Chart outlines a framework for incorporating preventive health services recommended by the WPSI, U.S. Preventive Services Task Force (USPSTF), and Bright Futures based on age, health status, and risk factors. In accordance with previous guidelines for preventive care, this document fails to offer recommendations or guidelines for infertility screening and fertility counseling in the course of well-woman care. Healthcare providers may be less likely to address fertility with their patients in the absence of clear, evidence-based recommendations, potentially resulting in underinformed reproductive choices and compromised reproductive potential...

BACKGROUND: The risk of venous thromboembolism (VTE) postpartum is modified by mode of delivery, with the risk of VTE being higher after cesarean compared to vaginal delivery. The risk of VTE following peripartum hysterectomy is largely unknown. OBJECTIVE: The objective of this study was to compare the incidence and risk of VTE among women who had and did not have a peripartum hysterectomy. We also sought to compare the risk of VTE after hysterectomy with other patient, pregnancy, and delivery risk factors known to be associated with VTE...

OBJECTIVE: Combined oral contraceptives are often considered a treatment option for women with premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) also seeking contraception, but evidence for this treatment is scarce. We aimed to determine 1) the level of evidence for the efficacy of combined oral contraceptives in managing premenstrual depressive symptoms and overall premenstrual symptomatology, and 2) the comparative efficacy of combined oral contraceptives (PROSPERO registration number CRD42020205510)...

BACKGROUND: Severe pertussis infection has been reported in infants prior to receiving routine immunization series. This problem could be solved by vaccinating mothers during pregnancy or children at birth. OBJECTIVE: The aim of the study is to conduct a systematic review and meta-analysis of randomized control trials and real-world evidence to evaluate the optimal strategy for pertussis vaccination. STUDY DESIGN: PubMed, Embase, and Cochrane Library databases were searched until December 2020...