Obstetri ve Jinekoloji

Thorough evaluation of a rectovaginal fistula (RVF) is essential to optimize surgical repair. The underlying cause should be addressed and treated, which can affect the timing as well as approach to repair. It is imperative to be well-prepared as the

Although endometriosis is a common condition—affecting ∼10% of premenopausal individuals—its etiology is unknown. Diet receives large patient attention, but studies of the role of diet are limited. Examining dietary patterns is essential to provide new insight.

Brain injury and poor neurodevelopment have consistently been reported in infants and adults born preterm. These changes occur at least in part prenatally and are associated with intra-amniotic inflammation. The pattern of brain changes has been partially documented by magnetic

Mature cystic teratomas represent nearly 60% of benign ovarian neoplasms across all age groups. We aim to update existing descriptive studies of ovarian teratomas including the epidemiology, rate of torsion/malignancy, and treatment modalities in a large modern cohort of patients.

EFM is used in the vast majority of US hospital births, but has significant limitations in achieving its intended goal of preventing intrapartum hypoxic-ischemic injury. Novel deep learning techniques can improve complex data processing and pattern recognition in medicine.

The authors regret the authorship affiliations are incorrect on the originally published abstract. The correct authorship and affiliations are:

Maternal deaths resulting from opioid use disorder (OUD) have been rising across the United States​. OUD among pregnant persons is associated with adverse pregnancy outcomes including preterm birth along with racial disparities in optimal OUD care.

Birthing people with de novo postpartum hypertensive disorders remain among the highest risk for severe maternal morbidity. Randomized controlled trials demonstrate a benefit to oral loop-diuretics in decreasing postpartum hypertensive morbidity in patients with an antenatal diagnosis of preeclampsia. It

Improved technologies paired with an increase in access to genetic testing has led to the availability of expanded carrier screening evaluating hundreds of disorders. Currently, most autosomal dominant mutations, such as BRCA1, are not included in expanded carrier assays. Screening

2023 British Society of Abortion Care Providers Conference Abstracts These oral abstracts were presented at the 2023 British Society of Abortion Care Providers (BSACP) Annual Conference on 10 November 2023 titled: ‘Excellence in Abortion Care Together: Coming together as a

The Society for Maternal-Fetal Medicine (SMFM) acknowledges gun violence as a public health crisis in the United States, with a significant impact on pregnant and postpartum people. We recognize the urgent need for a robust, equitable, data-driven approach to mitigate

The Society for Maternal-Fetal Medicine supports federal and state policies that expand Medicaid eligibility and extend Medicaid coverage through 12 months postpartum to address the maternal morbidity and mortality crisis and improve health equity. Access to coverage is essential to

Gestational diabetes mellitus (GDM) is associated with obstetrical and long-term cardiovascular complications. While platelet hyperresponsiveness in type-2 diabetes mellitus has been well-characterized and shown to play a crucial role in cardiovascular complications, this aspect has been little studied in GDM.

Umbilical artery gas results help obstetricians to assess fetal well being during the course of labor and guide screening decisions on eligibility for therapeutic hypothermia or also know as whole body or head cooling. The accuracy of results, especially base

Postpartum depression affects 10-20% of birthing people and is associated with changes in healthcare utilization. Little is known about the association between postpartum depressive symptoms and choice to use contraception, however both un- or under-treated depression and short interpregnancy intervals

A consensus standardized definition of success after stress urinary incontinence surgical treatment is lacking, which precludes comparisons between studies and affects patient counseling.

Contemporary guidance for preoperative feeding allows solids up to six hours and clear fluid up to two hours before anesthesia. Clinical trial evidence to support this approach for cesarean section is lacking. Many medical practitioners continue to follow conservative policies

Postpartum vulvovaginal hematoma is a complication of vaginal delivery that may progress to life-threatening conditions. However, the management of hematomas, including conservative therapy, surgery, and arterial embolization, is yet to be standardized.

Preterm birth (PTB) is one of the most frequent complications of pregnancies in women with systemic lupus erythematosus (SLE). The high indicated PTB proportion due to hypertensive disorders of pregnancy and/or fetal growth restriction is well known, and preventive measures

National Vital Statistics System reports show that maternal mortality rates in the United States have nearly doubled, from 17.4 in 2018 to 32.9 per 100,000 live births in 2021. However, these high and rising rates could reflect issues unrelated to

Concomitant use of efavirenz-based antiretroviral therapy and a standard-dose etonogestrel contraceptive implant resulted in 82% lower etonogestrel exposure compared to women not receiving antiretroviral therapy. The clinical impact of this reduced exposure is supported by retrospective cohort evaluations which demonstrated

Postpartum depression (PPD) is one of the most common complications after childbearing. Urinary incontinence (UI) is a frequent symptom during pregnancy and the postnatal period, often being the first time that women suffer from it. The aims of this systematic

A commitment to diversity, equity, inclusion, and belonging in medical education requires addressing both explicit and implicit biases based on sexual orientation, gender identity and expression and sex characteristics (SOGIESC) and the intersectionality with other identities. Heterosexism and heteronormative attitudes

Guidelines for management of first-trimester spontaneous and induced abortion vary regarding RhD testing and Rho(D) immune globulin administration. These existing guidelines are based on limited data that do not convincingly demonstrate the safety of withholding Rho(D) immune globulin for first-trimester

The authors regret, that corrections following publication of the manuscript have been made as the mean incidence reported by included studies of anal incontinence with fourth degree tears is 32.4%, not 28.6%. In addition, we have now included the overall

Intrapartum antibiotic prophylaxis is effective in preventing early-onset group B streptococcal disease in newborn infants, but it influences gut microbiota development. Gut microbiota composition is in turn associated with immune-related diseases in childhood.

Cervical cancer incidence in premenopausal women is rising, and fertility-sparing surgery offers an important option in this young population. There is a lack of evidence about what tumor size cutoff should be used to define candidacy for fertility-sparing surgery.

Venous thromboembolism accounts for approximately 9% of pregnancy-related deaths in the United States. National guidelines recommend postpartum risk stratification and pharmacologic prophylaxis in at-risk individuals. Knowledge on modern rates of postpartum pharmacologic thromboprophylaxis and its associated risks is limited.

Antenatal betamethasone is recommended before preterm delivery to accelerate fetal lung maturation. However, its optimal dose remains unknown. A 50% dose reduction was proposed to decrease the potential dose-related long-term neurodevelopmental side effects, including psychological development, sleep, and emotional disorders.

In recent years, active surveillance has been introduced as an alternative to excisional treatment in younger women with cervical intraepithelial neoplasia grade 2 (CIN2) since regression rates are high and because excisional treatment is associated with increased risk of preterm

Endometriosis is a chronic gynecological disorder that results in significant pain and reduced quality of life. While its physiological manifestations have been explored, its impact on mental health is less well-defined. Existing studies of endometriosis and mental health are situated

The FDA-approved, segesterone acetate/ethinyl estradiol, ring-shaped contraceptive vaginal system, known was Annovera (Sever Pharma Solutions/QPharma, Malmö, Sweden inserted and removed under a woman’s control for a 21 day in/7 day out regimen for up to 13 cycles of use.

In 2018, cisgender women accounted for nearly 20% of new HIV infections, with women of color disproportionately affected. HIV pre-exposure prophylaxis uptake, adherence, and persistence is paramount to ending the HIV epidemic, but current strategies to promote it have not

The symptom of heavy menstrual bleeding has a significant impact on professional, physical and social functioning. In 2021, results from a randomized controlled trial comparing a 52 mg levonorgestrel-releasing intrauterine system and radiofrequency non-resectoscopic endometrial ablation as treatments for women

Hypertensive disorders of pregnancy (HDP), including preeclampsia (PE) are associated with an increased risk of maternal cardiovascular disease, stroke and chronic kidney disease. However, their association with subsequent maternal dementia or cognitive impairment is less well understood. To review and

Intrapartum cardiotocographic monitoring of fetal heart rate by abdominal external ultrasound transducer without simultaneous maternal heart rate recording has been associated with increased risk of early neonatal death and other asphyxia-related neonatal outcomes. It is unclear, however, whether this increase

There is evidence suggesting that COVID-19 vaccination may be associated with small, transitory effects on uterine bleeding, possibly including menstrual timing, flow, and duration, in some individuals. However, changes in health care seeking, diagnosis, and workup for abnormal uterine bleeding

Adults with developmental disabilities often have less access to reproductive health services than adults without these disabilities. However, little is known about how adolescents with developmental disabilities, including autism, access reproductive health care.

Background Menstruation is a universal human experience from menarche to menopause. It is estimated that approximately 26% of the global population menstruates, with approximately 800 million individuals menstruating each day.1 While menstruation is considered a healthy vital sign and physiological

Preterm delivery is associated with cardiovascular remodeling and dysfunction in children and adults. However, it is unknown whether these effects are caused by the neonatal consequences of preterm birth or if these are already present in utero.

Ovarian tissue cryopreservation has been proven to preserve fertility against gonadotoxic treatments. It has not been clear how this procedure would perform if planned for the purpose of slowing ovarian aging.

Little is known about maintenance of amenorrhea in transgender and gender diverse individuals with uteri using long-term testosterone gender-affirming hormone therapy. Emerging data describes breakthrough bleeding in adolescents on long-term testosterone, as well as in adults seeking gender affirming hysterectomy.

Pelvic floor disorders after childbirth have distressing lifelong consequences for women, requiring more than 300,000 women to have surgery annually. This represents approximately 10% of the 3 million women who give birth vaginally each year. Vaginal birth is the largest

Many countries have implemented active surveillance (ie, leaving the lesion untreated) as an option among younger women with cervical intraepithelial neoplasia grade 2 because regression rates are high and excisional treatment increases the risk for preterm birth in subsequent pregnancies.

Women with normotensive pregnancy are at a reduced risk of developing cardiovascular disease postpartum compared to those who experience hypertensive conditions during pregnancy. However, the underlying mechanisms remain poorly understood. During normotensive pregnancy, vast numbers of placental extracellular vesicles are

The rising rate of cesarean sections (CS) has led to an increased incidence of long long-term complications, including niche formation in the uterine scar. Niche development is associated with various gynecological complaints and complications in subsequent pregnancies, such as uterine

No fetal growth standard is currently endorsed for universal use in the US. Newer standards improve upon the methodologic limitations of older studies but before adopting into practice, it is important to know how recent standards perform at identifying fetal

We sought to describe the pharmacokinetics and pharmacodynamics of aspirin through pregnancy (first and third trimester), to identify covariates that significantly impact aspirin pharmacokinetics (PK) and to identify the relationship between aspirin pharmacokinetics and pharmacodynamics (PD).

More than 290 million people worldwide, and almost 2 million people in the United States, are infected with hepatitis B virus (HBV), a vaccine-preventable communicable disease. The estimated prevalence of chronic hepatitis B infection in pregnancy is estimated to be

The influence of SARS-CoV-2 infection post-embryo transfer on early pregnancy outcomes in in vitro fertilization (IVF) or intracytoplasmic sperm injection-embryo transfer (ICSI-ET) treatment remains inadequately understood. This knowledge gap endures despite an abundance of studies investigating the repercussions of preceding

The last two decades have seen dramatic growth in the number of obstetrics and gynecology hospitalists (OB/GYN hospitalists), and many hospitals have created obstetric-specific emergency departments. The goals of an obstetrics emergency department (OB ED) are to provide safe and

Women can develop post-traumatic stress disorder (PTSD) in response to experienced or perceived traumatic, often medically complicated, childbirth; U.S. prevalence of these events remains high. Currently, no recommended treatment exists in routine care for preventing or mitigating maternal childbirth-related PTSD

A decline in musculoskeletal health during pregnancy is an under-appreciated adverse outcome of pregnancy that can have immediate and long-term health consequences. High physical job demands are known risk factors for non-traumatic musculoskeletal disorders in the general working population. Evidence

The examination of 24-hour urinary total protein excretion is an essential parameter used for evaluating renal function and early detection of gestational complications. However, data on reference ranges of 24-hour urinary total protein excretion in normal pregnancy are scarce.

Trans-abdominal cerclage (TAC) is an effective surgical intervention for preterm birth prevention. Placement of cervical suture using port closure device for pre-pregnancy laparoscopic abdominal cerclage has been used at our unit in recent years. We report operative and pregnancy outcomes

Maternal depression is a serious condition that effects up to 1 in 7 pregnancies. Despite evidence linking maternal depression to pregnancy complications and adverse fetal outcomes, there remain significant gaps in its identification and treatment. More work is needed to

Whether myomectomy increases the risk of placenta accreta spectrum (PAS) in the following pregnancies remains controversial.

The full spectrum of associations between in utero cannabis exposure and adverse neonatal outcomes is still unclear.

To analyse and summarize the evidence on accuracy of different ultrasound methods in diagnosis of retained products of conception.

Labor and delivery can entail complications and severe maternal morbidities that threaten a woman’s life or cause her to believe that her life is in danger. Women with these experiences are at risk for developing post-traumatic stress disorder (PTSD). Postpartum

Very little is known about the prevalence and risk factors of postpartum depression among women with vaginal births without major pregnancy complications.

To investigate the prognostic role of concomitant histologic fetal inflammatory response with chorioamnionitis on neonatal outcomes through a systematic review and meta-analysis of existing literature.

This article provides an updated overview and critique of clinical quality measures relevant to obstetrical care. The history of the quality movement in the USA and the proliferation of quality metrics over the past quarter century are reviewed. Common uses

The authors regret an error in the manuscript and the long video narration. In the last sentence of the results section of the manuscript, the text should read, “Furthermore, the positive predictive value (PPV) of the ACOG criteria was calculated

The combination of deserts in maternal-fetal medicine coverage across the United States and the COVID-19 pandemic accelerated the implementation of telemedicine programs for maternal-fetal medicine care delivery. While telemedicine-based care has the potential to facilitate timely access to maternal-fetal medicine

The principal fetal energy source is glucose provided by placental transfer of maternal glucose. However, the placenta’s glucose consumption exhibits considerable variation. Hexokinase is the first and one of the rate-limiting enzymes of glycolysis that phosphorylates glucose to glucose 6-phosphate.

Cesarean hysterectomy is generally presumed to decrease maternal morbidity and mortality secondary to placenta accreta spectrum disorder (PAS). Recently, uterine-sparing techniques have been introduced in conservative management of PAS to preserve fertility and potentially reduce surgical complications. However, despite often

Respiratory syncytial virus is a leading cause of lower respiratory tract illness globally in children under 5 years. Each year, approximately 58,000 hospitalizations in the United States are attributed to respiratory syncytial virus. Infants aged 6 months and younger experience

Medicaid, unlike any other insurance mechanism, imposes a consent requirement on female patients desiring sterilization that must be completed at least 30 days, but no more than 180 days, prior to sterilization. Desired sterilization cannot be completed in the Medicaid

Proficiency in postpartum abdominal sterilization is a core objective that residents must acquire during residency as outlined by the Council on Resident Education in Obstetrics and Gynecology. Surgical sterilization remains a popular and effective form of contraception in the United

The difference in incidence of early onset sepsis (EOS) caused by Group B Streptococcus (GBS) among term neonates whose mothers receive first versus second-line intrapartum prophylaxis is poorly described.

Racial inequities in maternal morbidity and mortality persist into the postpartum period, leading to a higher rate of postpartum hospital use (PHU) among Black and Hispanic people. Delivery hospitalizations provide an opportunity to screen and identify people at high risk

Hypertension is a leading cause of adverse pregnancy outcomes. These outcomes disproportionately affect Black individuals. Reproductive life planning that includes patient-centered contraception counseling could mitigate the impact of unintended pregnancy.

Cesarean scar pregnancy (CSP) is an iatrogenic consequence of a prior cesarean delivery (CD). The gestational sac implants into a niche created by the incision of the previous CD, carrying a substantial risk for major maternal complications. The aim of

In the LIBERTY Long-Term Extension study, once-daily relugolix combination therapy (40 mg relugolix, estradiol 1 mg, norethindrone acetate 0.5 mg) significantly improved uterine fibroid-associated heavy menstrual bleeding over the 52-week treatment period in the overall study population.

As defined by the WHO, postpartum family planning (PPFP) focuses on the prevention of unintended and closely spaced pregnancies through the first 12 months following childbirth.1 Access to postpartum contraception supports both individual reproductive goals and population health outcomes, and

This article is a report of a two-day workshop, entitled “Social Determinants of Health and Obstetric Outcomes,” held during the Society for Maternal-Fetal Medicine 2022 Annual Pregnancy Meeting. Participants’ fields of expertise included obstetrics, pediatrics, epidemiology, health services, health equity,

There are few prospective studies using validated measures in the gynecologic surgical literature comparing patient-reported outcomes in open and minimally invasive hysterectomy within enhanced recovery after surgery pathways.

Females’ accelerated reproductive events represent the early onset of reproductive events involving puberty, menarche, pregnancy loss, first sexual intercourse, first birth, parity, and menopause. The purpose of this study was to explore the association between childhood adversity and females’ accelerated

The diagnosis of corpus callosum anomalies by prenatal ultrasound has improved over the last decade due to improved imaging techniques, scanning skills and the routine implementation of transvaginal neurosonography. Our aim was to investigate all cases of incomplete agenesis of

The US Food and Drug Administration (FDA) supports innovations to facilitate new indications for high-risk human papillomavirus (HPV) testing. This report describes the retrospective testing of stored specimens and analysis of existing data to efficiently and cost-effectively support a new

The charge to the Center for Drug Evaluation and Research (CDER) of the US Food and Drug Administration (FDA) is to ensure that drugs approved on the American market provide benefits that outweigh risks for the intended population.1–3

The anatomical descriptions and extents of radical hysterectomy often vary across the literature and operative reports worldwide. The same nomenclature is often used to describe varying procedures, and different nomenclature is often used to describe the same procedure, despite the

Hyperoxygenation has shown promise in improving suspicious fetal heart pattern in women in labour. However, the effect of hyperoxygenation on neonatal outcomes in women in labour with pathological fetal heart rate tracing has not been studied.

Epithelial ovarian cancer is an insidious disease, and women are often diagnosed when the disease is beyond curative treatment. Accordingly, identifying modifiable risk factors is of paramount importance. Inflammation predisposes an individual to cancer in various organs, but whether pelvic

Spontaneous preterm birth significantly increases the risk for a recurrent preterm birth (rPTB). Few identifiable clinical risk factors exist in counseling of rPTB. Furthermore, treatment with progesterone supplementation has not consistently prevented preterm birth in high-risk patients, but may be

Clerkship grades in obstetrics and gynecology play an increasingly important role in the competitive application process to residency programs. An analysis of clerkship grading practices has not been queried in the past two decades in our specialty.

In randomized trials, one primary outcome is typically chosen to evaluate the consequences of an intervention while other important outcomes are relegated to secondary outcomes. This issue is amplified for many obstetric trials in which an intervention may have consequences

Antenatal steroid therapy is increasingly central to the obstetric management of women at imminent risk of preterm birth. For women likely to deliver between 24 and 34 weeks’ gestation, antenatal steroid therapy is standard of care, conveying sizable benefits and

There is a growing literature base regarding menstrual changes following COVID-19 vaccination among premenopausal people. However, relatively little is known about uterine bleeding in postmenopausal people following COVID-19 vaccination.

To assess the effects on oncological outcomes of intrauterine manipulator use during laparoscopic hysterectomy for endometrial cancer.

Epigenetic clocks use CpG DNA methylation (DNAm) to estimate biologic age; acceleration is associated with cancer, heart disease, and shorter lifespan. Few studies evaluate DNAm age and pregnancy outcomes. AgeAccelGrim is a novel epigenetic clock that combines seven DNAm components.

Placenta accreta spectrum is a dangerous complication of pregnancy that is underdiagnosed and can result in massive hemorrhage, disseminated intravascular coagulation, massive transfusion, surgical injury, multisystem organ failure, and even death. Given the rarity and complexity, most obstetric hospitals and

Testosterone use among transgender people likely impacts their experience of sexual function and vulvovaginal pain via several complex pathways. Testosterone use is associated with decreased estrogen in the vagina and atrophic vaginal tissue, which may be associated with decreased vaginal

To quantify the association between mode of operative delivery in the second stage of labour (cesarean delivery versus operative vaginal delivery) and spontaneous preterm birth (sPTB) in a subsequent pregnancy.

With increased success, ovarian tissue cryopreservation has recently become a standard technique for fertility preservation. However, malignant cell introduction through ovarian tissue transplantation remains a major concern for patients with acute leukemias.

Severe maternal morbidity (SMM) has been increasing in the past few decades. Few studies have examined the risk of SMM among individuals experiencing a stillbirth versus a live birth.

Obstetrical hemorrhage is a relatively frequent obstetric complication, and a common cause of maternal morbidity and mortality worldwide. The majority of maternal deaths attributable to hemorrhage are preventable, thus developing rapid and effective means of treating postpartum hemorrhage is of

Placenta accreta spectrum disorders are associated with substantial maternal morbidity and mortality. Despite a preoperative diagnosis, the rate of complications remains high and the condition is generally associated with the need for a hysterectomy.

Modern families are created in various ways, and the “traditional family” consisting of a cisgender heterosexual couple in their first marriage with biological children is just 1 family type in modern societies.1 It has been demonstrated that concerns about welfare

Plant-based diets (PBD) have been associated to a lower risk of cardiovascular disease in non-pregnant adults, but specific evidence for their effects on risk of hypertensive disorders of pregnancy (HDP) is scarce.

Genital talc and douching are practices that can involve exposure to chemical compounds linked to certain gynecologic cancers. However, it is unclear if they are associated with fibroid risk or age at fibroid diagnosis among women.

To assess the risk of adverse maternal and perinatal complications in twin and singleton pregnancies affected by gestational diabetes mellitus (GDM), compared to the respective group without GDM.

This study aimed to investigate whether trophectoderm (TE) biopsy for preimplantation genetic testing (PGT) is associated with an increased risk of adverse obstetric and neonatal outcomes as compared with that in conventional in-vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) without PGT.

To evaluate the association between hCG and adverse pregnancy outcomes.

Grünebaum et al’s1 perspective “Is it time to modify the Apgar score?,” written in response to our article, “Associations between provider-assigned Apgar score and neonatal race,” was thought-provoking and a step in the right direction.2

Danaher BG, Seeley JR, Silver RK, et al. Trial of a patient-directed eHealth program to ameliorate perinatal depression: the MomMoodBooster2 practical effectiveness study. Am J Obstet Gynecol 2023;228:453.e1-10.

Previous studies reported conflicting results on the relationship between oxytocin use for labor augmentation and the risk of postpartum hemorrhage (PPH), probably because it is rather challenging to disentangle oxytocin use from labor dystocia.

The monumental reversal of Roe v. Wade dramatically impacted the landscape of reproductive healthcare access in the United States. The decision most significantly affects communities that have historically been and continue to be marginalized by systemic racism, classism, and ableism

Currently, 11-to-14 weeks detailed anatomical surveys are generally reserved for at-risk populations because of the lower incidence of major fetal anomalies in low-risk populations. That standard reflects, in part, the fact that until recently pregnant persons retained the option of

Central sensitization is frequently associated with chronic pelvic pain and requires specific management. The pain is described as hypersensitivity to an innocuous stimulus that is both widespread and persistent. However, no study has evaluated if central sensitization can be measured

Incontinence occurs frequently in the postpartum period. Several theoretical pathophysiological models may underlie the hypothesis that different types of management of the active phase of the second stage of labor have different effects on pelvic floor muscles and thus perhaps

The authors regret an error in the text of the manuscript. In the Results section, in reference to adverse events and reactions, urinary tract infection rates were reported but not also present in Table 3. The events listed in the table

Although gestational diabetes and delivering high-birth-weight infants are known to predict a higher risk of future type 2 diabetes, the association of hypertensive disorders of pregnancy and other adverse pregnancy outcomes with type 2 diabetes is not well-established.

Approximately 15% of all clinically recognized pregnancies in infertile patients result in spontaneous abortion. However, despite its potential to have a profound and lasting impact on physical and emotional wellbeing, the natural history of spontaneous abortion in women with infertility

Isthmic contractions are a frequent physiological phenomenon in pregnancy, sometimes triggered by bladder voiding. They can interfere with proper cervical length assessment and may lead to false images of placenta previa. However, there is limited research on the prevalence and

Recent studies have showed that oral valacyclovir 8g/day reduces significantly the vertical CMV transmission rate in women with primary CMV infection acquired periconceptionally or during the first trimester. The present individual patient data meta-analysis aims to assess the effectiveness and

Misinformation contributes to the perception that abortion has substantial health risks, despite the known safety of medication and aspiration abortion. We lack detailed information about which health risks the public believes are most likely.

Postpartum utilization of long-acting reversible contraception (LARC) has been found to be effective at increasing inter-pregnancy intervals, reducing unintended pregnancies, and optimizing health outcomes for mothers and babies. Among female active-duty military members, reproductive planning may be particularly important, yet

The recent Society for Maternal-Fetal Medicine Consult Series #65 provides a comprehensive review of transabdominal cervical cerclage. The present article condenses the consult recommendations regarding patient selection, counseling, and management into two simple one-page checklists, one for the primary obstetrical

Background In the 1980s, the term ‘contragestion’ was coined by French scientists investigating progesterone receptor modulators (PRMs). Contragestion refers to a method that works after ovulation and throughout luteal phase and beyond.1 A contragestive could prevent or disrupt implantation, which

Maternal anticoagulation use may increase indeterminate result rates on cell-free DNA (cfDNA) based screening, but existing studies are confounded by inclusion of individuals with autoimmune disease, which alone is associated with indeterminate results. Changes in chromosome level Z-scores are proposed

Clinical chorioamnionitis refers to the presence of maternal fever (≥38°C) and at least 2 clinical signs: (1) maternal tachycardia (>100 bpm), (2) fetal tachycardia (>160 bpm), (3) maternal leukocytosis >15,000/mm2, (4) purulent vaginal discharge, and (5) uterine tenderness. Few data

The efficacy of antenatal corticosteroids on neonatal preterm complications wanes beyond 7 days after treatment. The neurodevelopmental effects of longer treatment-to-birth intervals have not been adequately evaluated.

Preliminary data suggest that strict glycemic control in twin pregnancies with GDM may not improve outcomes but might increase the risk of fetal growth restriction.

Bacterial vaginosis (BV) is a risk factor for sexually transmitted infections (STI) including HIV. Adult African women have high prevalence of BV, but it is not known when first BV occurs.

To provide an up-to-date systematic review on “the long-term outcomes of bilateral salpingo-oophorectomy (BSO) at the time of hysterectomy” and perform a meta-analysis for the reported associations.

Rectovaginal colonization with Group B Streptococcus (GBS) during pregnancy has historically been shown to be associated with an increased risk of clinical chorioamnionitis and peripartum infectious morbidity. Newer observational data in the era of intrapartum antibiotic prophylaxis suggest a possible

Intrahepatic cholestasis of pregnancy (ICP) is associated with a 4 to 10-fold increase in the risk of stillbirth in the absence of intervention, leading to recommendations for antenatal assessment, ursodiol use, and often preterm or early term delivery. The objective

International guidelines recommend tailoring the radicality of hysterectomy according to the known pre-operative tumor characteristics in patients with early-stage cervical cancer.

Eviction in pregnancy has been shown to be associated with adverse birth outcomes. A safety net program focused on covering the costs of rent during pregnancy may aid in preventing adverse complications.

The use of race in maternal serum screening is problematic, since race is a social construct rather than a distinct biological classifier. Nevertheless, laboratories offering this testing are encouraged to use race-specific cut-off values for maternal serum screening biomarkers to

Unnecessary cesareans lead to increased maternal and neonatal morbidity and mortality. In 2020, Florida had a cesarean rate of 35.9%, the third highest in the nation. An effective quality improvement strategy to reduce overall cesarean rates is to decrease primary

Prior predictive models using logistic regression for stillbirth do not leverage the advanced and nuanced techniques involved in sophisticated machine learning methods, such as modeling non-linear relationships between outcomes.

Risk-reducing bilateral salpingo-oophorectomy reduces mortality from high grade serous carcinoma in patients with hereditary breast and ovarian cancer associated gene mutations. Ideal surgical management includes 5 steps outlined in 2005 by the Society of Gynecologic Oncology and the American College

The need for serial in-office non-stress tests (NSTs) adds significant burden to high-risk pregnancies and exacerbates care disparities.

We read with interest the publication “Associations between provider-assigned Apgar score and neonatal race” by Edwards et al.1 The authors reported that providers inaccurately assigned Black neonates significantly lower Apgar scores, which were driven by lower color scores. Full-term Black neonates

Individuals with cancer during pregnancy are a medically complex patient population that is anticipated to grow. A better understanding of this population and patterns of risk at time of delivery offers an opportunity for providers to mitigate maternal morbidity.

Triplet pregnancies are high-risk for both the mother and the infants. The risks for the infants include premature birth, low birth weight, and neonatal complications. As a result, the management of triplet pregnancies involves close monitoring and may include interventions,

The recent publication of Treatment for Mild Chronic Hypertension During Pregnancy (CHAP trial) has already changed the management of pregnant people with mild chronic hypertension. However, like any new intervention or change in management, we have encountered confusion regarding the

Few studies have directly compared different surgical procedures for uterine fibroids with respect to long-term health-related quality of life outcomes and symptom improvement.

Maternal sepsis is a significant cause of maternal morbidity and mortality and is a potentially preventable cause of maternal death. This Consult aims to summarize what is known about sepsis and provide guidance for the management of sepsis during pregnancy

Preeclampsia is a life-threating pregnancy disorder, especially preterm preeclampsia and early-onset preeclampsia, the heterogeneity and complexity of preeclampsia make it difficult to predict risk and develop treatments. Plasma cell-free RNA carries unique information from human tissue and may be useful

Many questions remain about the appropriate utilization of intrauterine balloon devices in postpartum hemorrhage after vaginal delivery refractory to first-line uterotonics. Available data suggest that an early use of intrauterine balloon tamponade might be beneficial.