American Journal of obstetrics and gynecology

BACKGROUND: Counselling of pregnancies complicated by pre- and periviable PROM to reach a shared decision-making is challenging and the current, limited evidence hampers the robustness of the information provided. OBJECTIVE: To elucidate the rate of obstetric and neonatal outcomes following expectant management for premature rupture of membranes (PROM) occurred before or at the limit of viability. STUDY DESIGN: Medline, Embase, Cinahl and Web of Science databases were searched electronically up to September 2023...

No abstract text is available yet for this article.

BACKGROUND: Preterm birth is a major cause of perinatal morbidity and mortality. It is unclear whether the introduction of a universal transvaginal ultrasound cervical length screening program in women at low risk for preterm delivery is associated with a reduction in the frequency of preterm birth. OBJECTIVE: To test the hypothesis that the introduction of a midtrimester universal transvaginal ultrasound cervical length screening program in asymptomatic singleton pregnancies without prior preterm delivery would reduce the rate of preterm birth at <37 weeks of gestation...

BACKGROUND: The gold standard treatment for advanced pelvic organ prolapse is sacrocolpopexy. However, the pre-operative features of prolapse that predict optimal outcomes are unknown. OBJECTIVES: We aimed to develop a clinical prediction model that uses pre-operative scores on the Pelvic Organ Prolapse Quantification examination to predict outcomes after minimally invasive sacrocolpopexy for stages 2, 3, and 4 uterovaginal prolapse and vaginal vault prolapse. STUDY DESIGN: A two-institution database of pre- and post-operative variables from 881 cases of minimally invasive sacrocolpopexy was analyzed...

BACKGROUND: Maternal deaths resulting from opioid use disorder (OUD) have been rising across the United States​. OUD among pregnant persons is associated with adverse pregnancy outcomes including preterm birth along with racial disparities in optimal OUD care. OBJECTIVE: We aimed to evaluate whether the Illinois Perinatal Quality Collaborative's (ILPQC) implementation of the Mothers and Newborns affected by Opioids - Obstetric quality improvement initiative was associated with improvement of OUD identification, provision of optimal OUD care for birthing patients, and reduction in racial gaps of optimal OUD care...

BACKGROUND: Birthing people with de novo postpartum hypertensive disorders remain among the highest risk for severe maternal morbidity. Randomized controlled trials demonstrate a benefit to oral loop-diuretics in decreasing postpartum hypertensive morbidity in patients with an antenatal diagnosis of preeclampsia. It is not known whether this same therapy benefits patients at risk for new-onset postpartum hypertension OBJECTIVE: To evaluate whether oral furosemide can reduce risk for de novo postpartum hypertension (dnPPHTN) among high-risk birthing people by reducing post-delivery blood pressure...

OBJECTIVE: Clinical-sonographic scoring systems, combining clinical features and ultrasound imaging markers have been proposed for the screening of placenta accreta spectrum (PAS) but their usefulness in different set-ups remains limited. The aim of this study was to assess and compare different clinical-sonographic score systems performed from the midst of pregnancy for the prenatal evaluation of patients at risk of PAS at birth. DATA SOURCES: PubMed/MEDLINE, Google Scholar, and Embase were searched between October 1982 and October 2022 to identify eligible studies...

Residents are actively involved in patient assessment and all aspects of patient care, and they are critical in providing nutritional support education and treatment for patients with cancer. This study aims to assess the nutritional knowledge and performance of resident physicians, providing insights into existing gaps in awareness and practices related to cancer nutrition. A total of 300 resident physicians undergoing standardized residency training in China participated in this study. An anonymous online questionnaire covering demographic characteristics, nutritional knowledge, clinical practice, and training requirements was designed and administered through the "Wenjuanxing" platform...

OBJECTIVE: To synthesize the existing evidence on perinatal outcomes following autologous cryopreserved ovarian tissue transplantation (ACOTT), concurrently identifying key factors influencing these outcomes. DATA SOURCES: We performed a comprehensive search of MEDLINE, Embase, and Cochrane Library databases to identify relevant studies on the impact of ACOTT on perinatal outcomes from inception until October 22, 2023. Where there is missing information, the authors were contacted for updated data...

BACKGROUND: Improved technologies paired with an increase in access to genetic testing has led to the availability of expanded carrier screening evaluating hundreds of disorders. Currently, most autosomal dominant mutations, such as BRCA1, are not included in expanded carrier assays. Screening pregnant or preconception reproductive-aged women for BRCA1 may present a unique opportunity to perform population-based screening for patients at a time where precancer screening, chemoprevention and/or risk reducing surgery may be beneficial...

OBJECTIVE: Hepatic infarction is a rare complication of pregnancy most often associated with hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome. The objective of this review is to identify risk factors, presenting signs and symptoms, methods of diagnosis, and best management practices based on published case reviews. DATA SOURCES: PUBMED and MEDLINE: OVID databases were searched for citations regarding hepatic infarction in pregnancy or the postpartum period since database inception until the study date of December 18, 2023...

OBJECTIVE: To review current literature and guidelines on antiseptic surgical site preparations for preventing surgical site infections with consideration of contraindications specific to head and neck surgery. DATA SOURCES: PubMed/MEDLINE, clinicaltrials.gov, accessdata.fda.gov, Manufacturer websites. REVIEW METHODS: A scoping review on the literature and clinical studies comparing the efficacy of different surgical site preparations. Studies were included if they were a randomized controlled trial (RCT) comparing at least two commonly used and available antiseptic preparations...

The preconception consultation has traditionally centered pregnancy as desired and preordained. Separating preconception and contraceptive visits burdens patients and further fragments reproductive healthcare. We argue that the creation of a combined preconception and complex contraception clinic for individuals with significant medical and obstetric comorbidities is one approach to promoting reproductive autonomy. Pregnancy planning, prevention, and risk evaluation (PrePPARE) clinics are designed to review pregnancy related risks in the setting of patients' medical and obstetric comorbidities, recommend strategies to reduce risks, and, if desired, provide contraceptive methods...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND: Surgical site infection (SSI) is one of the most common complications of gynecologic cancer surgery. Current guidelines recommend the administration of cefazolin pre-operatively to reduce SSI rates for patients undergoing clean-contaminated surgeries such as hysterectomy. OBJECTIVE: To evaluate the impact of a quality improvement project adding metronidazole to cefazolin for antibiotic prophylaxis on SSI rate for women undergoing gynecologic surgery at a comprehensive cancer center...

The Society for Maternal-Fetal Medicine (SMFM) acknowledges gun violence as a public health crisis in the United States, with a significant impact on pregnant and postpartum people. We recognize the urgent need for a robust, equitable, data-driven approach to mitigate the impact of access to firearms and accompanying violence on pregnant and postpartum individuals and communities. As such, SMFM endorses the following policy principles: - SMFM calls on relevant government agencies and public funders to support and finance anti-violence and firearm safety research, public health surveillance activities, education, and other initiatives...

BACKGROUND: Standardization of procedures improves outcomes. Though systematic reviews have summarized the evidence-based steps (EBS) of cesarean delivery (CD), their bundled implementation has not been investigated. OBJECTIVE: In this pre- and post-implementation trial, we sought to ascertain if bundled EBS of CD, compared to surgeon's preference, improves outcomes. STUDY DESIGN: A StaRI (Standards for Reporting Implementation Studies) compliant, multi-center pre- and post-implementation trial at 4 teaching hospitals was conducted...

OBJECTIVE Artificial Intelligence (AI)-based text generators such as ChatGPT have come into the forefront of modern medicine. Given the similarity between AI-generated and human composed text, tools need to be developed to quickly differentiate the two. Previous work has shown that simple grammatical analysis can reliably differentiate AI-generated text from human written text. STUDY DESIGN In this study, ChatGPT was used to generate 25 articles related to obstetric topics similar to those made by the American College of Obstetrics and Gynecology (ACOG)...