American Journal of Obstetrics and Gynecology

Following a collaborative workshop at the 39th Annual Pregnancy Meeting, the Society for Maternal-Fetal Medicine Reproductive Health Advisory Group identified a need to assess attitudes of maternal-fetal medicine subspecialists about abortion services and available resources at the local and regional levels. The purpose of this study was to identify trends in attitudes, beliefs, and behaviors of practicing maternal-fetal medicine subspecialists in the United States regarding abortion. An online survey was distributed to Associate and Regular members of the Society for Maternal-Fetal Medicine assessing their personal training experience, abortion practice patterns, factors that influence their decision to provide abortion care, and their responses to a series of scenarios about high-risk maternal or fetal medical conditions...

No abstract text is available yet for this article.

BACKGROUND: The postpartum year is a vulnerable period for women with opioid use disorder, with increased rates of fatal and non-fatal overdose, yet the continuation of the use of medications to treat opioid use disorder (MOUD) on a population-level remains unknown. OBJECTIVES: To examine the discontinuation of methadone and buprenorphine among women with opioid use disorder in the year following delivery and determine the extent to which maternal and infant characteristics are associated with time to discontinuation of MOUD...

No abstract text is available yet for this article.

Inflammatory breast cancer (IBC) is a rare and aggressive malignancy that is often initially misdiagnosed due to its similar presentation to more benign breast pathology such as mastitis, resulting in treatment delays. Presenting symptoms of IBC include erythema, skin changes such as peau d' orange or nipple inversion, edema, and warmth of the affected breast. The average age at diagnosis is younger than in non-IBC. Known risk factors include African-American race and obesity. Diagnostic criteria include erythema occupying at least one-third of the breast, edema, peau d' orange, and/or warmth, with or without an underlying mass; rapid onset of fewer than three months; and pathologic confirmation of invasive carcinoma...

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BACKGROUND: Fetal fraction of cell free DNA decreases with increasing maternal weight. Consequently, cell-free DNA screening for fetal aneuploidy has higher screen failures or "no call" rates in women with obesity due to a low fetal fraction. The optimal timing of testing based on maternal weight is unknown. OBJECTIVE: To identify the optimal timing of initial cell-free DNA testing based on maternal weight and to identify the optimal timing of repeat cell-free DNA testing in cases with an initial screen failure...

Fetal and Neonatal AlloImmune Thrombocytopenia (FNAIT), the platelet equivalent of Hemolytic Disease of the Fetus and Newborn (HDFN), can have devastating effects on both the fetus and neonate. Current management of FNAIT in a subsequent affected pregnancy involves antenatal administration of IVIG and prednisone to the pregnant woman in order to prevent the development of severe fetal thrombocytopenia and secondary intracranial hemorrhage (ICH) in utero. That therapy has proven to be highly effective, but is associated with maternal side effects and is expensive...

Gestational surrogacy in the United States has quadrupled since 1999, but to date, few states explicitly permit compensated gestational surrogacy. Current legal prohibitions are often influenced by outdated and stereotyped understandings of surrogacy. It is increasingly important to understand the current literature on the medical and mental health impacts of surrogacy, as well as how state legislatures have addressed compensated gestational surrogacy in recent years. In this review, we find that there are no significant adverse medical or psychological outcomes for women who are gestational carriers or the children they give birth to...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND: Maternal chronic kidney disease (CKD) and chronic hypertension (CH) have been linked with adverse pregnancy outcomes. We aimed to examine the association between these conditions and adverse pregnancy outcomes over the last three decades, and to examine if the risk was modified by parity, maternal age, and body mass index (BMI). We also investigated whether different subtypes of CKD had differing effects. METHODS: We used data from the Swedish Medical Birth Register (MBR), including 2,788,490 singleton births between 1982 and 2012...

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BACKGROUND: In women with late preterm pre-eclampsia the optimal time of delivery is controversial, because of the fine balance between maternal benefits from early delivery and the risks for prematurity. It remains challenging to define prognostic markers to identify women at the highest risk of complication, in which a selective planned delivery may reduce maternal and perinatal adverse outcomes. OBJECTIVE: This trial aimed to determine whether using an algorithm based on maternal levels of placental growth factor (PlGF) in women with late preterm pre-eclampsia to decide the best time of delivery reduced the progression to pre-eclampsia with severe features without increasing the adverse perinatal outcomes...

No abstract text is available yet for this article.

BACKGROUND: Placental pathological lesions suggesting maternal (MVM) or fetal (FVM) vascular malperfusion are common among pregnancies complicated by fetal growth restriction (FGR). Data on the relationship between pathological placental lesions and subsequent infant neurodevelopmental outcomes are limited. OBJECTIVE: The aim of the study was to assess the relationship between placental pathological lesions and infant neurodevelopmental outcomes at two years of age in a cohort of pregnancies complicated by FGR...

BACKGROUND: Women with chronic hypertension are at increased risk of adverse maternal and perinatal outcomes. Maternal serum angiogenic markers, such as soluble fms like tyrosine kinase-1 (sFlt-1) and placental like growth factor (PlGF), can be used to triage women with suspected preeclampsia. However data on these markers in pregnant women with chronic hypertension are scarce. OBJECTIVE: We aimed to evaluate the predictive accuracy of maternal serum sFlt-1, PlGF and their ratio for predicting adverse maternal and perinatal outcomes in women with chronic hypertension...

BACKGROUND: The characteristics of antiphospholipid syndrome (APS)-associated HELLP syndrome are poorly described, likely due to the low frequency of this combination of syndromes. OBJECTIVE: To compare the characteristics and prognosis of HELLP syndrome in patients with and patients without APS. STUDY DESIGN: In this multicentric case-control study, adult women diagnosed with HELLP syndrome before 34 weeks' gestation, and who were also tested for antiphospholipid antibodies according to international diagnostic recommendations, were included...

BACKGROUND: Understanding and improving obstetric quality and safety is an important goal of professional societies, and many interventions such as checklists, safety bundles, educational interventions, or other culture changes have been attempted to improve the quality of care provided to obstetric patients. Although many factors contribute to delivery decisions, less work has addressed how provider issues such as fatigue or behaviors surrounding impending changes in shift may influence delivery mode and outcomes...

The postpartum period represents a critical window of opportunity to improve maternal short- and long-term health, including optimizing postpartum recovery, providing effective contraception, caring for mood disorders, managing weight, supporting lactation, initiating preventive care, and promoting cardiometabolic health. However, inadequate postpartum care, especially for individuals facing social and structural barriers, is common in the United States and contributes to suboptimal health outcomes with lasting consequences...