Obstetrics

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Women who receive the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) may not be at increased risk of preterm birth or other adverse birth outcomes, according to a new study in JAMA.

A small study by investigators from Harvard University suggests that cryopreserved embryo transfer (CET) is a strong independent risk factor for placenta accreta in women undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI).

The 7th annual March of Dimes Premature Birth Report Card shows that in 2013, the preterm birth rate fell to its lowest in 17 years-11.5%--meeting Healthy People 2020 goals. That number, however, still earns a “C” grade from the organization, which has set a goal of 9.6% of all live births by 2020.

A patient handout prepared by the Society for Maternal-Fetal Medicine to aid in understanding of periviable rupture of membranes.

From a medical perspective, the care and treatment appeared to be appropriate, and the patient’s cause of death was speculative. However, from a litigation perspective, the perinatologists were fighting an uphill battle.

A recent population-based study showed a lack of correlation between Joint Commission indicators of elective delivery at 39 weeks’ gestation and cesarean delivery and rates of maternal and neonatal complications in deliveries at New York City hospitals in 2010.

A study of nearly 1.5 million births in the United States shows that while rates of cesarean delivery vary widely from hospital to hospital, identifying the underlying cause with existing data is difficult. The findings underscore a need for collection by hospitals of comprehensive patient data in order to fully understand and optimize use of cesarean delivery.

According to a recent study in Fertility and Sterility, assisted reproductive technology (ART) does not increase the risk of autism spectrum disorder (ASD) in children conceived using the technology.

A computerized decision-support guide may help women make more informed choices about prenatal testing, according to results of a randomized trial published in JAMA. The findings, which require validation in other populations, suggest that, were women better educated about the technology, fewer prenatal tests would be done.

A behavioral program that includes group meetings can help reduce pregnancy weight gain in obese women and the prevalence of large-for-gestational-age (LGA) infants, according to the results of a study supported by the National Institute of Child Health and Human Development. The findings, from a randomized clinical trial (RCT), were published in Obesity.

The US Preventive Services Task Force (USPSTF) has issued a new report supporting prophylaxis with low-dose aspirin (81 mg/d) after 12 weeks’ gestation in women at high risk of preeclampsia.

In this era of highly regulated medical training, most residency and fellowship programs establish rigorous educational objectives and procedural curricula for their trainees. Guided by the expectations set by ACOG and ABOG, Ob/Gyn training programs rely upon structured didactic sessions and guided reading recommendations to keep their residents in compliance with these benchmarks.

A recent report from the Centers for Disease Control and Prevention shows that the number of induced deliveries is on the decline after almost 20 years of increases. The data are taken from the Natality Data File from the National Vital Statistics System and represent births in singleton deliveries, which are the majority of newborns.