Notes

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) fetuses. Sonographic diagnosis of fetal head deflexion was an independent risk factor for cesarean delivery both in occiput anterior (adjusted odds ratio, 5.37; 95% confidence interval, 1.819-15.869) and occiput posterior (adjusted odds ratio, 13.9; 95% confidence interval, 1.958-98.671) cases, and it was an independent risk factor for cesarean delivery regardless of the occiput position (adjusted odds ratio, 5.83; 95% confidence interval, 2.47-13.73).

The sonographic diagnosis of fetal head deflexion at the beginning of the second stage increases the risk of cesarean delivery.
The sonographic diagnosis of fetal head deflexion at the beginning of the second stage increases the risk of cesarean delivery.
Chlamydia trachomatis is a common bacterial sexually transmitted infection that can persist or recur after antibiotic treatment. Universal screening for chlamydia in pregnancy is recommended to prevent adverse birth outcomes. selleck products Single-dose oral azithromycin has been the first-line therapy for chlamydia in pregnancy since2006.

In the setting of limited data and rising sexually transmitted infection rates in the United States, our goal was to document rates and risk factors for persistent or recurrent chlamydia after azithromycin treatment in pregnancy.

This retrospective cohort study included pregnancies with urogenital chlamydia and follow-up testing in women who delivered at an Alabama facility between November 2012 and December 2017. Pregnancies with prescribed azithromycin therapy and repeat chlamydia testing ≥21 days later were included. Chlamydia trachomatis nucleic acid amplification testing was performed on genital swab or urine samples. Descriptive characteristics and birth outcomes were compared detected in nearly 1 in 4 pregnancies with repeat testing in our urban center, highlighting the importance of performing a test of cure and ensuring partner therapy to reduce recurrent chlamydia risk.
This study aimed to estimate the effect of antenatal corticosteroid administration on neonatal mortality and morbidity in preterm small-for-gestational age infants through a systematic review and meta-analysis.

A predefined, systematic search was conducted through Ovid MEDLINE, Embase, Scopus, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, World Health Organization International Clinical Trial Registry Platform, and ClinicalTrials.gov yielding 5324 articles from 1970 to2019.

Eligible studies compared neonatal morbidity and mortality among small-for-gestational age infants delivered preterm who received antenatal corticosteroids with those who did not.

The primary outcome was neonatal mortality. Secondary outcomes were respiratory distress syndrome, necrotizing enterocolitis, intraventricular hemorrhage and periventricular leukomalacia, bronchopulmonary dysplasia or chronic lung disease of prematurity, or neonatal sepsis. We assessed heterogeneity by means of Hsupports the use of antenatal corticosteroids to reduce neonatal mortality in pregnancies with small-for-gestational age infants at risk of preterm birth.
Pregestational diabetes mellitus is associated with a higher risk of adverse pregnancy outcomes. Based on the available data, it is unclear whether infants born preterm to mothers with pregestational diabetes mellitus are at a higher risk of adverse outcomes than other preterm infants.

This study aimed to quantify the neonatal complications associated with pregestational diabetes mellitus in infants born preterm.

This was a retrospective cohort study of all nonanomalous singleton neonates born in Texas from 2006 to 2014. Analysis was limited to births between 24 and 36 weeks' gestation and excluded multiple births, stillbirths, fetal congenital anomalies, neonates born to mothers with gestational diabetes mellitus, and neonates born to mothers with chronic hypertension. Results were stratified by pregestational diabetes mellitus status. Neonatal outcomes of interest included infant death, neonatal intensive care unit admission, low 5-minute Apgar scores, assisted ventilation of >6 hours, surfactant a of assisted ventilation of >6 hours, neonatal intensive care unit admission, and seizure. Neonates born to mothers with pregestational diabetes mellitus in the late preterm period between 34 and 36 weeks' gestation had an increased risk of low Apgar score at 5 minutes, assisted ventilation of >6 hours, surfactant use, and neonatal intensive care unit admission.

Pregestational diabetes mellitus is associated with a higher risk of adverse neonatal outcomes in infants born preterm.
Pregestational diabetes mellitus is associated with a higher risk of adverse neonatal outcomes in infants born preterm.
The prenatal diagnosis of an isolated congenital heart defect is a matter of concern for parents. The decision of whether to terminate the pregnancy according to the different types of congenital heart defects has not been investigated yet.

This study aimed to evaluate the frequency of voluntary termination of pregnancy after the prenatal diagnosis of a congenital heart defect in a tertiary care center.

This was a retrospective study of patients who were referred to our center from January 2013 to December 2019, underwent fetal echocardiography, and were counseled by a perinatologist and a pediatric cardiologist. The following data were collected prenatal diagnosis, including genetic testing; gestational age at diagnosis; and outcome of pregnancy. The diagnoses were stratified retrospectively according to the type of congenital heart defect and its severity (low complexity, moderate complexity, and high complexity) by a perinatologist and a pediatric cardiologist.

Of 704 women who received a diagnosiso terminate a pregnancy after the diagnosis of a fetal congenital heart defect is influenced by the surgical complexity of the congenital heart defect itself. However, most patients, including those with the most severe forms of congenital heart defect, decided to continue the pregnancy.
Vasa previa represents a rare prenatal finding with potentially life-threatening risk to the fetus.

This study aimed to describe the natural history of prenatally diagnosed vasa previa and evaluate the association between antenatally diagnosed vasa previa and adverse obstetrical and neonatal outcomes.

This was a multicenter descriptive and retrospective study of patients diagnosed prenatally with vasa previa on transvaginal ultrasound in the New York City Maternal-Fetal Medicine Research Consortium centers between 2012 and 2018. Outcomes evaluated included persistence of vasa previa at the time of delivery, gestational age at delivery, indications for unplanned unscheduled delivery, and neonatal course.

A total of 165 pregnancies with vasa previa were included, of which 16 were twin gestations. link2 Forty-three cases (26.1%) were noted to resolve on subsequent ultrasound. Of the remaining 122 cases with persistent vasa previa, 46 (37.7%) required unscheduled delivery. Twin gestations were nearly 3 times as likely to require unscheduled delivery as singleton gestations (73.3% vs 25.2%; P<.001). Most infants (70%) were admitted to the neonatal intensive care unit. There was 1 neonatal death (0.9%) because of complications related to prematurity.

Despite the low neonatal mortality rate with prenatal detection of vasa previa, one-third of patients required unscheduled delivery, and more than half of neonates experienced complications related to prematurity.
Despite the low neonatal mortality rate with prenatal detection of vasa previa, one-third of patients required unscheduled delivery, and more than half of neonates experienced complications related to prematurity.
Studies have shown an association between the incidence of gestational diabetes and living in neighborhoods oversaturated with unhealthy foods.

This study sought to determine if the food environment also affects the management of gestational diabetes. We hypothesized that living in areas with a higher quality of food decreased the risk of requiring medication to treat gestational diabetes.

This was a retrospective cohort study of singleton births at the Christiana Care Health System between 2015 and 2018. Patients with gestational diabetes who live in Delaware (N=1327) were geocoded and classified according to their census tract food environment. The food environment was assessed using the modified Retail Food Environment Index, which measures the percentage of healthy food retailers among all food retailers within a half-mile radius of the census tract boundaries. The modified Retail Food Environment Index scores were divided into 3 categories poor (modified Retail Food Environment Index score, 0-3), aent Index score, ≥11 [adjusted odds ratio, 0.56; 95% confidence interval, 0.40-0.82]). They also had a lower prevalence of type II diabetes mellitus (modified Retail Food Environment Index score, 4-10 [adjusted odds ratio, 0.25; 95% confidence interval, 0.09-0.72] and modified Retail Food Environment Index score, ≥11 [adjusted odds ratio, 0.48; 95% confidence interval, 0.27-0.86]). There were no differences in the other secondary outcomes of interest.

The food environment affects the requirement for medication to obtain glycemic levels that are within the target range for those with gestational diabetes.
The food environment affects the requirement for medication to obtain glycemic levels that are within the target range for those with gestational diabetes.
Few adequately validated patient-reported outcome measures are available, which can assess recovery profiles following childbirth.

We aimed to determine whether quantitative recovery (using the Obstetric Quality of Recovery-10 patient-reported outcome measure) was superior following vaginal delivery compared with cesarean delivery and evaluate validity, reliability, and responsiveness of this patient-reported outcome measure in the obstetrical setting in the United States.

Women recruited into this single-center observational cohort study completed the Obstetric Quality of Recovery-10 and EuroQol 5-dimension 3L patient-reported outcome measures within 72 hours of childbirth. We assessed the validity with hypothesis testing and structural validity. In hypothesis testing, the primary outcome was Obstetric Quality of Recovery-10 scores after vaginal vs cesarean delivery. Secondary outcomes were differences in Obstetric Quality of Recovery-10 scores for vaginal delivery following induction of labor vs spontmine how to improve recovery domains identified in this study, to evaluate Obstetric Quality of Recovery-10 in different languages and determine whether these domains impact outcomes beyond hospitalization.
The publication of invalid scientific findings may have profound implications on medical practice. As the incidence of article retractions has increased over the last 2 decades, organizations have formed, including Retraction Watch, to improve the transparency of scientific publishing. At present, the incidence of article retraction in the obstetrics and maternal-fetal medicine literature is unclear.

This study aimed to determine the number of retracted articles within the obstetrics and maternal-fetal medicine literature from the PubMed and Retraction Watch databases and examine reasons for retraction.

A retrospective review of the PubMed and Retraction Watch databases was performed to identify retracted articles in the obstetrics and maternal-fetal medicine literature from indexation through December 31, 2019. The primary outcome was defined as the number of identified articles and reason for retraction. link3 Within PubMed, articles were identified using a medical subheading search for articles categorized as withdrawn or retracted.
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