Labor and Delivery

“The c-section you do today impacts the future health of the woman you’re caring for.” So said Aaron B. Caughey, MD, of Oregon Health & Science University, Portland, in his lunch-and-learn “The Cesarean Epidemic: Etiologies, Outcomes and Potential Solutions” on Monday. What’s more, he pointed out, “the c-section you do today leads to the repeat … [which] leads to the repeat … [which] leads to the accreta in 8 years.” But Caughey did not place blame for the so-called epidemic with either doctors or patients.

According to a recent study in The Lancet, a reduction in preterm births and childhood hospital visits for asthma are additional benefits to public smoking bans.

Was there an unreasonable delay in making the diagnosis, and did that delay have an effect on the patient’s treatment and overall life expectancy?

A review of the latest agents and strategies for treating venous thromboembolic events (VTE) in both pregnant and nonpregnant women.

According to a new study in Tobacco Control, women exposed to secondhand smoking (SHS), particularly those with no history of smoking, have a higher risk of spontaneous abortions, ectopic pregnancies, and stillbirths than women with no such exposure.

An iliac artery rupture results in a patient's death. Was it caused by the cesarean delivery, the patient’s disease process, or the care she received following her delivery?

Rates of cesarean delivery have risen, and with them, interest in determining what influence-if any-progress and management of labor have on the uptick. A retrospective chart review presented at the 34th Annual Meeting of the Society for Maternal-Fetal Medicine: The Pregnancy Meeting suggests that labor curves are unchanged and a better understanding of labor management is needed to reverse the cesarean trend.

“Term” delivery is defined as 39 weeks 0 days, according to the American College of Obstetricians and Gynecologists. For women with repeat cesareans, that timing may not result in the best outcomes, say investigators from the University of Texas Medical School at Houston.

High body mass index (BMI) and short stature are risk factors for cesarean delivery across all racial/ethnic groups, according to a study to be presented at the 34th Annual Meeting of the Society for Maternal-Fetal Medicine: The Pregnancy Meeting on February 7, 2014 in New Orleans.

A reader writes regarding the November 2013 article "The transcervical Foley balloon." Are there any data that this method of induction is connected to higher rates of umbilical cord prolapse?

The use of forceps and the vacuum extractor shouldn't be allowed to become a lost art.

A child's disabilities are found to be unrelated to the events that occurred at her birth.

According to a new retrospective cohort study in Obstetrics & Gynecology, timely initiation of progestin in women with a history of preterm delivery is associated with a reduction in spontaneous preterm delivery.

According to a recent study, parity and mode of delivery do not have a significant impact on women's long-term sexual satisfaction.

Pregnant patients who have undergone some form of bariatric surgery are at greater risk of preterm birth than women who haven’t had the procedure, according to a study published in the British Medical Journal. The risk of small for gestational age (SGA) was also increased in women with previous bariatric surgery.

A low-cost instrument that an auto mechanic invented to ease assisted vaginal delivery is being tested by the World Health Organization (WHO). If proven safe and effective, the Odon Device would be the first innovation in operative vaginal delivery since the forceps and vacuum extractor.

Non-white women with low levels of vitamin D are more likely to deliver preterm than white mothers, according to a new study in the American Journal of Epidemiology.

Six states received an “A” grade on the March of Dimes’s 2013 Premature Birth Report Card but the country overall achieved only a “C.” That is despite a drop in rates of preterm birth for the sixth consecutive year.

A new study in Anesthesia & Analgesia indicates that the incidence of severe and fatal sepsis during labor and delivery is on the rise in the United States.

There is no evidence that UCP can be prevented, but rapid diagnosis and delivery have been shown to be advantageous. The authors present a plan to help you respond surely and swiftly.

An ob/gyn neglects to follow a molar pregnancy to its conclusion and the patient develops choriocarcinoma. A jury found in favor of the plaintiff.

In his August 2013 editorial, editor in chief Dr. Charles Lockwood discusses recent findings that obese women have a higher risk of extremely early preterm delivery.

A commentary on some of the best research in this field published in the past year

The common practice of clamping an umbilical cord within a minute of birth to reduce the possibility of maternal hemorrhaging may need to be revised, according to a new paper published in The Cochrane Database of Systematic Reviews. The study authors searched the Cochrane Pregnancy and Childbirth Group’s Trials Register to find 15 trials involving a total of 3911 mother and infant pairs. The risk of bias in the trials was considered by the paper’s authors to be moderate in nature.

After rising steadily for nearly a decade, the rate of cesarean deliveries appears to have stabilized, according to a new report (www.cdc.gov/nchs/data/databriefs/db124.pdf) from the National Center for Health Statistics. New guidelines and policies encouraging longer gestations have led to a trend of cesarean deliveries occurring more frequently at 39 weeks than at 38 weeks.

Doing nothing is no longer an option, say the authors. Cervical length assessment should be provided to a larger population of women to identify and treat those with cervical shortening.

Three major Ohio universities and 4 hospitals have joined with the March of Dimes Foundation to establish a new collaborative research program aimed exclusively at finding the unknown causes of premature birth.