Obstetrics and Gynecology

Gabrielle Côté-Poirier, Nazila Bettache, Anne-Marie Côté, Michèle Mahone, Francine Morin, Annabelle Cumyn, Yves-André Bureau, Mandy Malick, Nadine Sauvé
OBJECTIVE: To evaluate complications associated with early postpartum therapeutic anticoagulation. METHODS: A multicenter retrospective cohort study was done to evaluate the association between therapeutic anticoagulation postpartum and major complications (hemorrhagic and wound complications). Secondary outcomes included minor complications, risk factors associated with total complications (including the time to therapeutic anticoagulation resumption after delivery) and recurrent thrombotic events within 6 weeks postpartum...
July 9, 2020: Obstetrics and Gynecology
Anna Whelan, Channing Burks, Mary D Stephenson
No abstract text is available yet for this article.
July 9, 2020: Obstetrics and Gynecology
Michael J Beninati, Sebastian Z Ramos, Valery A Danilack, Phinnara Has, David A Savitz, Erika F Werner
OBJECTIVE: To identify characteristics associated with vaginal delivery compared with cesarean delivery after labor induction among women with hypertensive disorders of pregnancy and to develop and validate a prediction model to assist in clinical care. METHODS: We studied a retrospective cohort of women with singleton pregnancies who had hypertensive disorders of pregnancy and who underwent induction of labor at 34 weeks of gestation or more from January 1, 2002, to March 31, 2013...
July 9, 2020: Obstetrics and Gynecology
Erika Banks, Gregory M Gressel, Karen George, Mark B Woodland
OBJECTIVE: To assess self-reported readiness of U.S. obstetrics and gynecology residents to perform surgical procedures compared with the perceptions of their program directors. METHODS: The 2019 Council on Resident Education in Obstetrics and Gynecology Survey assessed resident self-confidence and perceived readiness to independently perform common surgical procedures. Concurrently, obstetrics and gynecology residency program directors were surveyed about the readiness of their graduating residents to independently perform the same procedures...
July 9, 2020: Obstetrics and Gynecology
William M Leininger, Pratima Gupta
In recognition of the 100 anniversary of women's suffrage, we reviewed the difficulties reformists overcame in passing the 19th Amendment and discuss the similarities to current challenges in providing evidence-based, affordable, accessible women's health care. Many current health care problems arise from systemic, not medical, issues, and we can better focus on them through the lenses of the social determinants of health and reproductive justice. Addressing systemic inadequacies and injustices requires policy implementation and legislative activism, like that pursued by the suffragists...
July 9, 2020: Obstetrics and Gynecology
Sarah Bundrick Grimes, Arame Thiam Diouf, César Francisco Saldaña-Solórzano, Nancy C Chescheir
No abstract text is available yet for this article.
July 9, 2020: Obstetrics and Gynecology
Ankita Gupta, Kate Meriwether, Molly Tuller, Michael Sekula, Jeremy Gaskins, J Ryan Stewart, Deslyn Hobson, Olivia Cardenas-Trowers, Sean Francis
OBJECTIVE: To evaluate differences in physical function at 6 weeks after vaginal surgery among women positioned in candy cane and boot stirrups. METHODS: We conducted a single-masked, randomized controlled trial of women undergoing vaginal surgery with either candy cane or boot stirrup use. The primary outcome was a change in the PROMIS (Patient-Reported Outcomes Measurement Information System) physical function short form-20a from baseline to 6 weeks after surgery...
July 9, 2020: Obstetrics and Gynecology
Kate Swanson, Joseph M Letourneau, Miriam Kuppermann, Brett D Einerson
OBJECTIVE: To evaluate whether deviation from American Society for Reproductive Medicine (ASRM) safety guidelines for women who are gestational carriers is associated with increased risk of severe obstetric and perinatal morbidity and mortality. METHODS: This is a cross-sectional study of births from gestational carrier pregnancies in Utah from 2009 to 2018 with data collected from birth certificates. Deviations from ASRM guidelines include women aged younger than 21 years or older than 45 years, nulliparity, prior stillbirth, tobacco or percutaneous drug use, more than five prior deliveries, more than three prior cesarean deliveries, major comorbidities, and mental health conditions...
July 9, 2020: Obstetrics and Gynecology
Jeffrey B Gould, Anisha M Abreo, Shen-Chih Chang, Elliott K Main
OBJECTIVE: To assess whether there is a relationship between evening, night, and weekend births and severe unexpected neonatal morbidity in low-risk term singleton births. METHODS: We conducted a population-based, cross-sectional analysis. Severe unexpected neonatal morbidity as defined by the National Quality Forum specification 0716 was derived from linked birth certificate and hospital discharge summaries for 1,048,957 low-risk singleton term Californian births during 2011 through 2013...
July 9, 2020: Obstetrics and Gynecology
Awa Sanneh, Tricia Murdock, Stephanie L Wethington, Amanda N Fader, Deyin Xing, Anna L Beavis
BACKGROUND: Morcellation at the time of minimally invasive hysterectomy or myomectomy for presumed benign indications carries a risk of disseminating undiagnosed uterine malignancies. CASE: A 57-year-old woman with a remote history of laparoscopic hysterectomy with morcellation of a cellular leiomyoma presented with a newly diagnosed complex pelvic mass. Owing to adherence of the mass to the rectum and numerous peritoneal tumor implants, a surgical cytoreductive procedure was performed...
July 9, 2020: Obstetrics and Gynecology
Catherine A Matthews, Elizabeth J Geller, Barbara R Henley, Kimberly Kenton, Erinn M Myers, Alexis A Dieter, Brent Parnell, Christina Lewicky-Gaupp, Margaret G Mueller, Jennifer M Wu
OBJECTIVE: To compare mesh and permanent suture exposure rates in the first year after minimally invasive total hysterectomy and sacrocolpopexy with a light-weight polypropylene mesh using permanent or delayed absorbable sutures. METHODS: Across five centers in the United States, women were randomized to permanent or delayed absorbable suture for vaginal attachment of a Y-mesh during hysterectomy and sacrocolpopexy for stage II prolapse and worse. The primary outcome was mesh or permanent suture exposure in the first year after surgery...
July 9, 2020: Obstetrics and Gynecology
Alison B Edelman, Bliss Kaneshiro, Katharine B Simmons, Jennifer L Hauschildt, Kise Bond, Emily R Boniface, Jeffrey T Jensen
OBJECTIVE: To evaluate whether a short course of tamoxifen decreases bothersome bleeding in etonogestrel contraceptive implant users. METHODS: In a 90-day, double-blind randomized control trial, we enrolled etonogestrel implant users with frequent or prolonged bleeding or spotting. A sample size of 40 per group (N=80) was planned to compare 10 mg tamoxifen or placebo twice daily for 7 days after 3 consecutive days of bleeding or spotting no more than once per 30 days (maximum three treatments)...
July 9, 2020: Obstetrics and Gynecology
Annie M Dude, Charlotte Niznik, Alan M Peaceman, Lynn M Yee
OBJECTIVE: To examine whether an insulin protocol for intrapartum glucose control among parturients with diabetes was associated with improved outcomes. METHODS: This is a retrospective cohort study of women with pregestational or gestational diabetes delivering a liveborn neonate at Northwestern Memorial Hospital. Before 2011, women with diabetes were given intravenous (IV) insulin or glucose during labor at the discretion of the on-call endocrinologist. In 2011, a standardized protocol was designed to titrate insulin and glucose infusions...
July 9, 2020: Obstetrics and Gynecology
John J Byrne, Emma M Smith, Alexander M Saucedo, Kaitlin A Doody, Denisse S Holcomb, Catherine Y Spong
OBJECTIVE: To evaluate the association of increasing body mass index (BMI) on postpartum tubal ligation safety and estimate the rates of procedure complication. METHODS: We conducted a single-institution, retrospective review. Women undergoing postpartum permanent contraception after vaginal delivery from August 2015 to March 2019 were studied. Our primary outcome included a composite morbidity of intraoperative complications (bleeding requiring additional surgery, and extension of incision), blood transfusion, aborted procedure, anesthetic complication, readmission, wound infection, venous thromboembolism, ileus or small bowel obstruction, incomplete transection, and subsequent pregnancy...
July 9, 2020: Obstetrics and Gynecology
Pablo Garcia-Manau, Itziar Garcia-Ruiz, Carlota Rodo, Elena Sulleiro, Nerea Maiz, Marina Catalan, Nuria Fernández-Hidalgo, Joan Balcells, Andrés Antón, Elena Carreras, Anna Suy
BACKGROUND: The risk of vertical transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains unknown. Positive reverse-transcription polymerase chain reaction (RT-PCR) test results for SARS-CoV-2 infection in neonates and placental tissue have been reported, and immunoglobulin M antibodies have been detected in neonates born to mothers with infection. CASES: The first case is a woman at 22 3/7 weeks of gestation with coronavirus disease 2019 (COVID-19) who was admitted to the intensive care unit...
July 7, 2020: Obstetrics and Gynecology
Mariam Naqvi, Phillip Zakowski, Lindsey Glucksman, Sarah Smithson, Richard M Burwick
BACKGROUND: There are limited data regarding treatment options for pregnant women with severe coronavirus disease 2019 (COVID-19). CASE: A 35-year-old primigravid patient at 22 weeks of gestation presented with 7 days of fever, cough, anosmia, and dyspnea. Nasopharyngeal swab was positive for the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and a chest X-ray demonstrated bilateral patchy infiltrates. Laboratory evaluation was notable for marked elevation of interleukin-6 and C-reactive protein concentrations...
June 30, 2020: Obstetrics and Gynecology
Suzanne Slayton-Milam, Samantha Sheffels, Dominic Chan, Bashar Alkinj
BACKGROUND: In the global coronavirus disease 2019 (COVID-19) pandemic, to date, delivery of critically ill pregnant patients has predominantly been by cesarean. CASE: A 27-year-old pregnant woman was admitted to a 166-bed community hospital at 33 weeks of gestation with acute hypoxemic respiratory failure secondary to COVID-19. She underwent mechanical ventilation for 9 days. While ventilated, she underwent induction of labor, resulting in a successful forceps assisted-vaginal birth...
June 23, 2020: Obstetrics and Gynecology
Rasha Khoury, Peter S Bernstein, Chelsea Debolt, Joanne Stone, Desmond M Sutton, Lynn L Simpson, Meghana A Limaye, Ashley S Roman, Melissa Fazzari, Christina A Penfield, Lauren Ferrara, Calvin Lambert, Lisa Nathan, Rodney Wright, Angela Bianco, Brian Wagner, Dena Goffman, Cynthia Gyamfi-Bannerman, William E Schweizer, Karina Avila, Bijan Khaksari, Meghan Proehl, Fabiano Heitor, Johanna Monro, David L Keefe, Mary E DʼAlton, Michael Brodman, Sharmila K Makhija, Siobhan M Dolan
OBJECTIVE: To describe the characteristics and birth outcomes of women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection as community spread in New York City was detected in March 2020. METHODS: We performed a prospective cohort study of pregnant women with laboratory-confirmed SARS-CoV-2 infection who gave birth from March 13 to April 12, 2020, identified at five New York City medical centers. Demographic and clinical data from delivery hospitalization records were collected, and follow-up was completed on April 20, 2020...
June 16, 2020: Obstetrics and Gynecology
Romeo R Galang, Karen Chang, Penelope Strid, Margaret Christine Snead, Kate R Woodworth, Lawrence D House, Mirna Perez, Wanda D Barfield, Dana Meaney-Delman, Denise J Jamieson, Carrie K Shapiro-Mendoza, Sascha R Ellington
OBJECTIVE: To inform the current coronavirus disease 2019 (COVID-19) outbreak, we conducted a systematic literature review of case reports of Middle East respiratory syndrome coronavirus (MERS-CoV), severe acute respiratory syndrome coronavirus (SARS-CoV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, during pregnancy and summarized clinical presentation, course of illness, and pregnancy and neonatal outcomes. DATA SOURCES: We searched MEDLINE and ClinicalTrials...
June 16, 2020: Obstetrics and Gynecology
Torri D Metz, Charlene Collier, Lisa M Hollier
Individual state maternal mortality review committees aim to comprehensively review all maternal deaths to not only evaluate the cause of death, but also to assess preventability and make recommendations for action to prevent future deaths. The maternal mortality review committee process remains critical during the coronavirus disease 2019 (COVID-19) pandemic. Maternal deaths due to COVID-19 have been reported in the United States. Some state maternal mortality review committees may choose to expedite review of these deaths in an effort to quickly provide clinicians with information intended to prevent other deaths during the ongoing pandemic...
June 16, 2020: Obstetrics and Gynecology
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