Obstetrics

The use of labor neuraxial analgesia for vaginal delivery was associated with a 14% decrease in the risk of severe maternal morbidity (SMM), including postpartum hemorrhage (PPH), compared to vaginal delivery without neuraxial analgesia, according to a study published in JAMA Network Open.

A retrospective cohort study published in JAMA found that pregnant and postpartum women with SARS-CoV-2 infection were at a significantly increased risk of maternal mortality or serious morbidity from common obstetric complications.

An integrated model for prenatal care that incorporates both virtual and in-person visits has been well-received by patients and health care providers alike, according to a review in the Journal of Midwifery & Women’s Health.

A study published in American Journal of Preventive Medicine compared prenatal care in women with various disabilities.

From SMFM, a visual summary of Consult #60.

This Consult discusses the management of pregnancies achieved with in vitro fertilization and provides recommendations based on the available evidence.

An analysis of more than 100 mother-child pairs from Colorado found children with fetal exposure to cannabis had increased fat mass and fasting glucose levels compared to their counterparts without fetal exposure to cannabis.

For extremely preterm infants, mother’s own milk may be helpful for preventing poor postnatal growth and some morbidities.

Bilateral oophorectomy is associated with an increased risk of dementia, according to findings from a prospective cohort study in the journal Menopause.

This Consult has been endorsed by the American College of Obstetricians and Gynecologists (ACOG) and replaces the Society for Maternal-Fetal Medicine's (SMFM) Statement #4, Implementation of the use of antenatal corticosteroids in the late preterm birth period in women at risk for preterm delivery, August 2016.

Evidence indicates that a delay in umbilical cord clamping leads to better outcomes for infants. What are the outcomes for those who are very preterm?

Substance use disorder may prove to be a significant issue for some mothers. In this article, experts discuss a case of addiction in pregnancy, analyzing the patient's medical history and psychosocial state.

An analysis of data from more than 100k pregnant women suggests a history of spontaneous abortion was associated with an 18% increase in risk of subsequent gestational diabetes, with a history of multiple spontaneous abortions associated with an even greater risk.

A cohort study examines the potential obstetrical outcomes associated with fertility-assisted pregnancies.

A report provides information on how gender-affirming care such as the use of puberty blockers can positively impact the mental health of transgender and nonbinary teenagers and young adults.

Risk factors for the dual burden of severe maternal morbidity and preterm birth differ significantly by insurance type across sociodemographic and perinatal considerations in the state of California, according to a study in the Maternal and Children Health Journal.

Because the treatment options for imminent extreme premature labor center largely on patient preference, decision aids (DA) can help facilitate the patient-provider discussion and guide the shared decision-making process.

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Experts evaluate 3 clinical scenarios and determine the appropriate course of action.

Effective each year on October 1, additions, deletions, and updates to the ICD-10-CM code set are published. This year, no significant changes were made to Chapter 15, the obstetrics chapter. However, there are a few new codes that could affect the practice of maternal-fetal medicine.

A review and meta-analysis in JAMA Network Open revealed women exposed to marijuana in pregnancy were at significantly increased risk for adverse neonatal outcomes, including low birth weight, small for gestational age, and preterm delivery.

An oral concurrent session at SMFM’s 42nd Annual Pregnancy Meeting highlighted an analysis of pregnancy outcomes after optimal prenatal opioid use disorder care.

An oral presentation at the Society for Maternal-Fetal Medicine’s (SMFM) 42nd Annual Pregnancy Meeting explored possible associations with marijuana use and nausea and vomiting in early pregnancy.

At the Society for Maternal-Fetal Medicine’s 42nd Annual Meeting, a roundtable discussion explored ways to promote inclusivity and support transgender and gender-expansive individuals in the women’s health space.

Researchers presented their oral abstract on the association between lactation and the gut microbiome during the SMFM 42nd Annual Pregnancy Meeting.

Protocol 5 - In this protocol, Norton reviews the pathophysiology of fetal aneuploidy and the wide range of tests for it. Included are perspectives on cell-free DNA testing, first-trimester combined screening, nuchal translucency (NT) sonography, and pregnancy-associated plasma protein A (PAPP-A) and human chorionic gonadotropin (hCG), as well as quad marker screening in the second trimester in appropriate cases, and combined first- and second-trimester screening.

These results suggest that maternal diet during pregnancy can significantly affect obesity risk in children.

Eating disorders carry many risks. An investigation looks into whether they can increase the risk of certain neurodevelopmental conditions in the children of mothers with a history of eating disorders.

Scientific advances have led to more extremely preterm infants surviving delivery. What are the outcomes for these infants?

Additionally, the study showed a 15-fold increase in maternal mortality rates associated with chronic hypertension over the 40-year study period.