Pregnancy and Birth

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In 2012, a Virginia woman began receiving prenatal care for her seventh pregnancy, during which she was diagnosed with Type II diabetes and obesity. During the delivery, shoulder dystocia was encountered. The baby's right arm was noted to be limp and she was diagnosed with a brachial plexus injury. The woman sued those involved with the delivery, claiming that during the course of her care, the history, physical examinations, and tests showed she had an increased risk for encountering shoulder dystocia during a vaginal delivery.

Cutting-edge medical advances and innovative technologies have made headlines and continue to flourish in the new millennium. However, these medical achievements stand in stark contrast to the paradoxical increase in US maternal mortality, which is among the highest of all developed nations.

A systematic review and meta-analysis suggests that in pregnancies conceived via assisted reproduction, risk of adverse perinatal outcomes may be higher with donated than with autologous oocytes. Plus: Do post-cesarean antibiotics reduce infections in obese women? Also: Researchers believe they have identified the genes associated with preterm delivery.

This article reviews complications that may occur following perineal trauma, techniques to help prevent these complications, and best practices for management using case vignettes.

Physiologic changes during pregnancy affect the body’s hormonal milieu as well as a woman’s sexual desires, responses, and practices. In this review, we discuss knowledge gaps, the physiology of the female sexual response during pregnancy, types of sexual activity during pregnancy, and existing literature on anatomic and physiologic changes by trimester and postpartum.

A new study looks at whether midpelvic operative deliveries have greater trauma than other delivery forms. Plus: A look at the long-term effects of using bisphosphonates. Also, is lithium use in early pregnancy as dangerous as previously thought?

Too many ob/gyns believe that doing something is better than doing nothing, says this reader.