American Journal of Obstetrics and Gynecology

The complement system is critical to human health due its central role in host defense and innate immunity. During pregnancy, the complement system must be appropriately regulated to allow for immunologic tolerance to the developing fetus and placenta. While some degree of complement activation can be seen in normal pregnancy, the fetus appears to be protected in part through placental expression of complement regulatory proteins, which inhibit complement activation at different steps along the complement activation cascade...

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BACKGROUND: Transgender, nonbinary, and gender-expansive (TGE) people who were assigned female or intersex at birth experience pregnancy and have abortions. No data have been published on individual abortion experiences or preferences of this understudied population. OBJECTIVE(S): To fill existing evidence gaps on the abortion experiences and preferences of TGE people in the United States to inform policies and practices to improve access to and quality of abortion care for this population...

BACKGROUND: COVID-19 may be associated with adverse maternal and neonatal outcomes in pregnancy, but there is little controlled data to quantify the magnitude of these risks or to characterize the epidemiology and risk factors. OBJECTIVE: To quantify the associations of COVID-19 with adverse maternal and neonatal outcomes in pregnancy and to characterize the epidemiology and risk factors. METHODS: We performed a matched case-control study of pregnant patients with confirmed COVID-19 (cases) who delivered between 16 and 41 weeks' gestation from March 11-June 11, 2020...

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The reported incidence of eclampsia is 1.6-10 per 10,000 deliveries in developed countries, where as it is 50-151 per 10,000 deliveries in developing countries. In addition, low resource countries have substantially higher rates of maternal and perinatal mortalities and morbidities. This disparity in incidence and pregnancy outcomes maybe related to universal access to prenatal care, early detection of preeclampsia, timely delivery, and availability of health care resources in developed as compared to developing countries...

Hidradenitis suppurativa is a chronic inflammatory disease that disproportionately affects women of childbearing age. Hidradenitis suppurativa is characterized by painful nodules, abscesses, draining dermal tunnels, and scarring with predilection for intertriginous sites, such as the axilla, groin, and breast regions. Delay in diagnosis and treatment of hidradenitis suppurativa often results in long-term sequelae leading to significant morbidity, and rarely mortality, in these patients. This Clinical Opinion suggests that Obstetrician-Gynecologists (ob-gyns) are uniquely poised to recognize early signs of hidradenitis suppurativa during routine well-woman exams and initiate treatment or referral to dermatology...

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Physiological transformation with remodeling of the uteroplacental spiral arteries is key to a successful placentation and normal placental function. It is an intricate process that involves, but is not restricted to, complex interactions between maternal decidual immune cells and invasive trophoblasts in the uterine wall. In normal pregnancy, the smooth muscle cells of the arterial tunica media of uteroplacental spiral arteries are replaced by invading trophoblasts and fibrinoid, and the arterial diameter increases 5-10-fold...

A vital mission of the Society for Maternal-Fetal Medicine (SMFM) is to provide independent, objective, scientifically-based information and recommendations for providers, patients, and payors of high-risk pregnancy care. To ensure that these recommendations are free from bias, special interest, or the perception of either, a publicly transparent process for disclosing relevant financial and nonfinancial interests (disclosures of interest, or DOI) and management of potential conflicts of interest (COIs) is essential...

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