Disease Severity and Perinatal Outcomes of Pregnant Patients With Coronavirus Disease 2019 (COVID-19).
al Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network Abstract OBJECTIVE: To describe coronavirus disease 2019 (COVID-19) severity in pregnant patients and evaluate the association between disease severity and perinatal outcomes. METHODS: We conducted an observational cohort study of all pregnant patients with a singleton gestation and a positive test result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who delivered at 1 of 33 U.S. hospitals in 14 states from March 1 to July 31, 2020. Disease severity was classified by National Institutes o...
Source: Obstetrics and Gynecology - February 8, 2021 Category: OBGYN Authors: Metz TD, Clifton RG, Hughes BL, Sandoval G, Saade GR, Grobman WA, Manuck TA, Miodovnik M, Sowles A, Clark K, Gyamfi-Bannerman C, Mendez-Figueroa H, Sehdev HM, Rouse DJ, Tita ATN, Bailit J, Costantine MM, Simhan HN, Macones GA, Eunice Kennedy Shriver Natio Tags: Obstet Gynecol Source Type: research

Comparison of Surgical Outcomes After Total Laparoscopic Hysterectomy or Total Vaginal Hysterectomy for Large Uteri.
CONCLUSION: In patients matched by uterine size and preoperative characteristics, total vaginal hysterectomy is not associated with an increased composite risk of major surgical morbidity or other adverse surgical outcomes. PMID: 33543889 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - February 4, 2021 Category: OBGYN Authors: Sailofsky S, Darin C, Alfahmy A, Sheyn D Tags: Obstet Gynecol Source Type: research

Pregnancy Outcomes Among Individuals Who Enrolled Compared With Declined Enrollment in A Randomized Trial of Induction Versus Expectant Management (ARRIVE).
PMID: 33543890 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - February 4, 2021 Category: OBGYN Authors: Gupta M, Tounsi S, Wagner S, Mendez-Figueroa H, Ortiz F, Blackwell SC, Chauhan SP Tags: Obstet Gynecol Source Type: research

Rethinking Second-Line Therapy for Overactive Bladder to Improve Patient Access to Treatment Options.
Abstract Idiopathic overactive bladder (OAB) is a chronic condition that negatively affects quality of life, and oral medications are an important component of the OAB treatment algorithm. Recent literature has shown that anticholinergics, the most commonly prescribed oral medication for the treatment of OAB, are associated with cognitive side effects including dementia. β3-adrenoceptor agonists, the only alternative oral treatment for OAB, are similar in efficacy to anticholinergics with a more favorable side effect profile without the same cognitive effects. However, there are marked cost variations and bar...
Source: Obstetrics and Gynecology - February 4, 2021 Category: OBGYN Authors: Escobar CM, Falk KN, Mehta S, Hall EF, Menhaji K, Sappenfield EC, Brown OE, Ringel NE, Chang OH, Tellechea LM, Barnes HC, Jeney SES, Bennett AT, Cardenas-Trowers OO Tags: Obstet Gynecol Source Type: research

Effects of the Coronavirus Disease 2019 (COVID-19) Lockdown on the Use of Contraceptives and Ovulation Inductors in France.
PMID: 33543892 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - February 4, 2021 Category: OBGYN Authors: Roland N, Drouin J, Desplas D, Cuenot F, Dray-Spira R, Weill A, Zureik M Tags: Obstet Gynecol Source Type: research

Understanding Rising Electronic Cigarette Use.
Abstract Vaping is the act of inhaling an aerosol generated by an electronic cigarette (e-cigarette), a battery-powered device that heats a reservoir of liquid, typically nicotine-containing, to deliver contents to the user. E-cigarettes were initially introduced as a means of smoking cessation, although evidence of their effectiveness is limited. There is a widespread perception that these products are a safer alternative to conventional cigarettes, driven in large part by marketing efforts by e-cigarette manufacturers. Yet to achieve vaporization, temperatures are so high that components of the device hardware, ...
Source: Obstetrics and Gynecology - February 4, 2021 Category: OBGYN Authors: Wylie BJ, Hauptman M, Hacker MR, Hawkins SS Tags: Obstet Gynecol Source Type: research

Measuring Female Veterans' Prepregnancy Wellness Using Department of Veterans Affairs' Health Record Data.
CONCLUSION: Despite limitations of administrative data, monitoring measures of prepregnancy wellness can provide benchmarks for improving women's health across health care systems and communities. Areas for intervention to improve female veterans' prepregnancy wellness include healthy weight, optimizing control of diabetes before pregnancy, and improved use and documentation of key prepregnancy health screenings. PMID: 33543894 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - February 4, 2021 Category: OBGYN Authors: Quinn DA, Mor MK, Sileanu FE, Zhao X, Callegari LS, Zephyrin LC, Frayne DJ, Borrero S Tags: Obstet Gynecol Source Type: research

Ensuring Equitable Implementation of Telemedicine in Perinatal Care.
Abstract The use of telemedicine in U.S. perinatal care has drastically increased during the coronavirus disease 2019 (COVID-19) pandemic, and will likely continue given the national focus on high-value, patient-centered care. If implemented in an equitable manner, telemedicine has the potential to reduce disparities in care access and related outcomes that stem from systemic racism, implicit biases and other forms of discrimination within our health care system. In this commentary, we address implementation factors that should be considered to ensure that disparities are not widened as telemedicine becomes more i...
Source: Obstetrics and Gynecology - February 4, 2021 Category: OBGYN Authors: Ukoha EP, Davis K, Yinger M, Butler B, Ross T, Crear-Perry J, Perron-Burdick M, Nijagal MA Tags: Obstet Gynecol Source Type: research

Associations Between Sexual Assault and Reproductive and Family Planning Behaviors and Outcomes in Female Veterans.
Abstract OBJECTIVE: To examine the relationship between lifetime sexual assault (defined as someone having experienced sexual assault in their lifetime) and reproductive health care seeking, contraception usage, and family planning outcomes in female veterans. METHODS: We conducted a secondary analysis of data collected between 2005 and 2008 from computer-assisted telephone interviews with 1,004 female veterans aged 20-52 years who were enrolled at two Midwestern Department of Veterans Affairs (VA) health care systems. Participants were asked about reproductive, mental, and general health histories, and about...
Source: Obstetrics and Gynecology - February 4, 2021 Category: OBGYN Authors: Edmonds SW, Mengeling MA, Syrop CH, Torner JC, Sadler AG Tags: Obstet Gynecol Source Type: research

Prophylactic Administration of Uterotonics to Prevent Postpartum Hemorrhage in Women Undergoing Cesarean Delivery for Arrest of Labor: A Randomized Controlled Trial.
CONCLUSION: Compared with oxytocin alone, prophylactic use of a combination of uterotonic drugs did not reduce the need for additional uterotonics at cesarean delivery for labor arrest. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT01869556. PMID: 33543897 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - February 4, 2021 Category: OBGYN Authors: Balki M, Downey K, Walker A, Seaward G, Carvalho JCA Tags: Obstet Gynecol Source Type: research

Laparoscopic Major Vascular Injuries in Gynecologic Surgery for Benign Indications: A Systematic Review.
CONCLUSION: The incidence of major vascular injury during gynecologic laparoscopy found in this review is very low, and the vast majority of injuries did not result in death. Laparoscopy remains a safe surgical technique in relation to vascular injuries when performed for benign gynecologic disease. PMID: 33543898 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - February 4, 2021 Category: OBGYN Authors: King NR, Lin E, Yeh C, Wong JMK, Friedman J, Traylor J, Tsai S, Chaudhari A, Milad MP Tags: Obstet Gynecol Source Type: research

Sex, Hormones, Immune Functions, and Susceptibility to Coronavirus Disease 2019 (COVID-19)-Related Morbidity.
Abstract Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), uses two primary receptors, type II transmembrane serine protease and angiotensin-converting enzyme-2, for priming and cellular invasion, respectively. Both proteins have been demonstrated to be present in different concentrations in females and males, which may explain a mechanism for the reported higher case-fatality rate in males. Despite the known sex difference in COVID-19 disease mortality, preliminary data suggest there are certain female populations, including pregnant and menop...
Source: Obstetrics and Gynecology - February 4, 2021 Category: OBGYN Authors: Gotluru C, Roach A, Cherry SH, Runowicz CD Tags: Obstet Gynecol Source Type: research

Acute Fatty Liver of Pregnancy.
This report offers anticipated recovery and management strategies for commonly associated complications. Application of these factors has served to decrease mortality from as high as 80% down to 10%; however, given the seriousness of this condition, severe maternal morbidities are frequently associated with this obstetric emergency. PMID: 33543900 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - February 4, 2021 Category: OBGYN Authors: Nelson DB, Byrne JJ, Cunningham FG Tags: Obstet Gynecol Source Type: research

Locating Hormone-Releasing Contraceptive Implants Using Near-Infrared Light.
CONCLUSION: Near-infrared light was successful in locating nonpalpable etonogestrel implants. This novel method can be used as an alternative to ultrasonography. PMID: 33543901 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - February 4, 2021 Category: OBGYN Authors: Akturk HK Tags: Obstet Gynecol Source Type: research

Reducing Perinatal Health Disparities by Placing Equity at the Heart of Performance Improvement.
Abstract Multiple studies have demonstrated that low income and Black women in the United States are more likely to suffer from severe maternal morbidity and mortality during childbirth, even when accounting for the site of service. Structural racism, social determinants of health, and personally mediated racism are factors that may play a role. Assessing them is, therefore, critical in the attempt to deliver safe and equitable health care, which is a fundamental charge of performance-improvement committees. We argue that, for performance-improvement committees to fulfill their mandate, they must include equity as...
Source: Obstetrics and Gynecology - February 4, 2021 Category: OBGYN Authors: Pardo C, Atallah F, Mincer S, Minkoff H Tags: Obstet Gynecol Source Type: research

Preimplantation Genetic Testing for Aneuploidy: A Review of the Evidence.
This article reviews all the published randomized controlled trials on preimplantation genetic testing for aneuploidy with comprehensive chromosome screening and comments on the subject of embryo mosaicism detected by this technique. Most of these trials have been criticized because they only included good prognosis patients having normal ovarian reserve producing a high number of embryos available for biopsy. Preimplantation genetic testing for aneuploidy does not improve ongoing pregnancy rates per cycle started when routinely applied on the general IVF population but seems to be a good tool of embryo selection for a sel...
Source: Obstetrics and Gynecology - February 4, 2021 Category: OBGYN Authors: Dahdouh EM Tags: Obstet Gynecol Source Type: research

Prematurity Rates During the Coronavirus Disease 2019 (COVID-19) Pandemic Lockdown in Melbourne, Australia.
PMID: 33543904 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - February 4, 2021 Category: OBGYN Authors: Matheson A, McGannon CJ, Malhotra A, Palmer KR, Stewart AE, Wallace EM, Mol BW, Hodges RJ, Rolnik DL Tags: Obstet Gynecol Source Type: research

Incidence of and Risk Factors for Failed Induction of Labor Using a Contemporary Definition.
Abstract OBJECTIVE: To estimate the incidence of failed induction of labor and the associated patient risk factors. METHODS: We performed a case-control study from a cohort of nulliparous women who delivered between 39 and 41 weeks of gestation after an induction of labor in one of seven hospitals. Cases of failed induction were defined using the Obstetric Care Consensus criteria (ie, cesarean delivery performed in early labor [less than 6 cm dilatation] after at least 12 hours of oxytocin administration from membrane rupture). For each case of failed induction, the next four women who did not meet the criter...
Source: Obstetrics and Gynecology - February 4, 2021 Category: OBGYN Authors: Freret TS, Woods GT, James KE, Kaimal AJ, Clapp MA Tags: Obstet Gynecol Source Type: research

Have Coronavirus Disease 2019 (COVID-19) Community Lockdowns Reduced Preterm Birth Rates?
PMID: 33543906 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - February 4, 2021 Category: OBGYN Authors: Goldenberg RL, McClure EM Tags: Obstet Gynecol Source Type: research

Customized Probability of Vaginal Delivery With Induction of Labor and Expectant Management in Nulliparous Women at 39 Weeks of Gestation.
PMID: 33481509 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Authors: Peleg D, Warsof PSL Tags: Obstet Gynecol Source Type: research

In Reply.
PMID: 33481510 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Authors: Silver RM, Rice MM, Grobman WA, Thom EA, Saade GR Tags: Obstet Gynecol Source Type: research

Contributions, Aspirations, and Challenges of Academic Specialist Divisions in Obstetrics and Gynecology.
PMID: 33481511 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Authors: Temkin SM, Terplan M Tags: Obstet Gynecol Source Type: research

In Reply.
PMID: 33481512 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Authors: LaCoursiere DY, Scott JR, Chelmow D, Young AE, Sawaya GF, DeLancey J, Learman LA Tags: Obstet Gynecol Source Type: research

ACOG Committee Opinion No. 804: Physical Activity and Exercise During Pregnancy and the Postpartum Period.
PMID: 33481513 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Authors: Syed H, Slayman T, DuChene Thoma K Tags: Obstet Gynecol Source Type: research

ACOG Committee Opinion No. 804: Physical Activity and Exercise During Pregnancy and the Postpartum Period.
sh; K PMID: 33481514 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Authors: Mota P, Bø K Tags: Obstet Gynecol Source Type: research

In Reply.
PMID: 33481515 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Authors: Birsner ML, Gyamfi-Bannerman C, Zahn CM Tags: Obstet Gynecol Source Type: research

Subcutaneous Buprenorphine Extended-Release Use Among Pregnant and Postpartum Women.
PMID: 33481516 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Authors: Bernstein SN, Peckham AM, Schiff DM, Gray JR Tags: Obstet Gynecol Source Type: research

In Reply.
PMID: 33481517 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Authors: Cleary EM, Kate Byron R, Hinely KA, Talley AW, Costantine MM, Rood KM Tags: Obstet Gynecol Source Type: research

Corticosteroids in the Management of Pregnant Patients With Coronavirus Disease (COVID-19).
PMID: 33481518 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Authors: Rosen T Tags: Obstet Gynecol Source Type: research

Corticosteroids in the Management of Pregnant Patients With Coronavirus Disease (COVID-19).
PMID: 33481519 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Authors: Mitra AR, Gellatly R, Rowe H, Johnson SR Tags: Obstet Gynecol Source Type: research

In Reply.
PMID: 33481520 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Authors: Saad AF, Chappell L, Saade GR, Pacheco LD Tags: Obstet Gynecol Source Type: research

Practice Bulletin No. 164: Diagnosis and Management of Benign Breast Disorders: Correction.
Authors: PMID: 33481521 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Obstet Gynecol Source Type: research

ACOG Publications: February 2021.
Authors: PMID: 33481522 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Obstet Gynecol Source Type: research

Fetal Growth Restriction: ACOG Practice Bulletin Summary, Number 227.
Authors: Abstract Fetal growth restriction, also known as intrauterine growth restriction, is a common complication of pregnancy that has been associated with a variety of adverse perinatal outcomes. There is a lack of consensus regarding terminology, etiology, and diagnostic criteria for fetal growth restriction, with uncertainty surrounding the optimal management and timing of delivery for the growth-restricted fetus. An additional challenge is the difficulty in differentiating between the fetus that is constitutionally small and fulfilling its growth potential and the small fetus that is not fulfilling its gro...
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Obstet Gynecol Source Type: research

Medically Indicated Late-Preterm and Early-Term Deliveries: ACOG Committee Opinion Summary, Number 818.
Authors: Abstract ABSTRACT: The neonatal risks of late-preterm and early-term births are well established, and the potential neonatal complications associated with elective delivery at less than 39 0/7 weeks of gestation are well described. However, there are a number of maternal, fetal, and placental complications in which either a late-preterm or early-term delivery is warranted. The timing of delivery in such cases must balance the maternal and newborn risks of late-preterm and early-term delivery with the risks associated with further continuation of pregnancy. Deferring delivery to the 39th week is not recom...
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Obstet Gynecol Source Type: research

Informed Consent and Shared Decision Making in Obstetrics and Gynecology: ACOG Committee Opinion Summary, Number 819.
Authors: Abstract ABSTRACT: Meeting the ethical obligations of informed consent requires that an obstetrician-gynecologist gives the patient adequate, accurate, and understandable information and requires that the patient has the ability to understand and reason through this information and is free to ask questions and to make an intentional and voluntary choice, which may include refusal of care or treatment. Shared decision making is a patient-centered, individualized approach to the informed consent process that involves discussion of the benefits and risks of available treatment options in the context of a pa...
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Obstet Gynecol Source Type: research

Breastfeeding Challenges: ACOG Committee Opinion Summary, Number 820.
Authors: Abstract ABSTRACT: Breastfeeding is associated with a decrease in a woman's risk of breast cancer, ovarian cancer, diabetes mellitus, and hypertensive heart disease. Breastfeeding initiation rates in the United States are increasing, and many women are aware of the maternal and infant health benefits of breastfeeding. However, problems may arise that can keep women from achieving their breastfeeding goals, and only 25% of women in the United States are breastfeeding exclusively at 6 months. Many women experience early and undesired weaning because of persistent pain or nipple injury. A focused history an...
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Obstet Gynecol Source Type: research

Barriers to Breastfeeding: Supporting Initiation and Continuation of Breastfeeding: ACOG Committee Opinion Summary, Number 821.
Authors: Abstract ABSTRACT: Breastfeeding has maternal, infant, and societal benefits. However, many parents experience obstacles to achieving their breastfeeding goals, leading to reduced rates of breastfeeding initiation and continuation. Despite efforts to increase rates of breastfeeding initiation and continuation, inequities still persist. The factors that influence an individual's desire and ability to breastfeed are varied and include individual parent considerations; practitioner influences; hospital barriers; societal factors, such as workplace and parental leave policies; access to lactation support; an...
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Obstet Gynecol Source Type: research

Fetal Growth Restriction: ACOG Practice Bulletin, Number 227.
Authors: Abstract Fetal growth restriction, also known as intrauterine growth restriction, is a common complication of pregnancy that has been associated with a variety of adverse perinatal outcomes. There is a lack of consensus regarding terminology, etiology, and diagnostic criteria for fetal growth restriction, with uncertainty surrounding the optimal management and timing of delivery for the growth-restricted fetus. An additional challenge is the difficulty in differentiating between the fetus that is constitutionally small and fulfilling its growth potential and the small fetus that is not fulfilling its gro...
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Obstet Gynecol Source Type: research

Medically Indicated Late-Preterm and Early-Term Deliveries: ACOG Committee Opinion, Number 818.
Authors: Abstract ABSTRACT: The neonatal risks of late-preterm and early-term births are well established, and the potential neonatal complications associated with elective delivery at less than 39 0/7 weeks of gestation are well described. However, there are a number of maternal, fetal, and placental complications in which either a late-preterm or early-term delivery is warranted. The timing of delivery in such cases must balance the maternal and newborn risks of late-preterm and early-term delivery with the risks associated with further continuation of pregnancy. Deferring delivery to the 39th week is not recom...
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Obstet Gynecol Source Type: research

Informed Consent and Shared Decision Making in Obstetrics and Gynecology: ACOG Committee Opinion, Number 819.
Authors: Abstract ABSTRACT: Meeting the ethical obligations of informed consent requires that an obstetrician-gynecologist gives the patient adequate, accurate, and understandable information and requires that the patient has the ability to understand and reason through this information and is free to ask questions and to make an intentional and voluntary choice, which may include refusal of care or treatment. Shared decision making is a patient-centered, individualized approach to the informed consent process that involves discussion of the benefits and risks of available treatment options in the context of a pa...
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Obstet Gynecol Source Type: research

Breastfeeding Challenges: ACOG Committee Opinion, Number 820.
Authors: Abstract ABSTRACT: Breastfeeding is associated with a decrease in a woman's risk of breast cancer, ovarian cancer, diabetes mellitus, and hypertensive heart disease. Breastfeeding initiation rates in the United States are increasing, and many women are aware of the maternal and infant health benefits of breastfeeding. However, problems may arise that can keep women from achieving their breastfeeding goals, and only 25% of women in the United States are breastfeeding exclusively at 6 months. Many women experience early and undesired weaning because of persistent pain or nipple injury. A focused history an...
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Obstet Gynecol Source Type: research

Barriers to Breastfeeding: Supporting Initiation and Continuation of Breastfeeding: ACOG Committee Opinion, Number 821.
Authors: Abstract ABSTRACT: Breastfeeding has maternal, infant, and societal benefits. However, many parents experience obstacles to achieving their breastfeeding goals, leading to reduced rates of breastfeeding initiation and continuation. Despite efforts to increase rates of breastfeeding initiation and continuation, inequities still persist. The factors that influence an individual's desire and ability to breastfeed are varied and include individual parent considerations; practitioner influences; hospital barriers; societal factors, such as workplace and parental leave policies; access to lactation support; an...
Source: Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Obstet Gynecol Source Type: research

The Contrast of Color: Why the Black Community Continues to Suffer Health Disparities.
Abstract The evidence of racial health disparities is profound. Much attention has been given to the disparity in maternal morbidity and mortality experienced by Black mothers. The disparity in Black lives lost from coronavirus disease 2019 (COVID-19) has further highlighted the disparity in health outcomes for Black people. Although COVID-19 is a new disease, the reason for the health disparity is the same as in maternal morbidity and mortality: implicit bias and structural racism. Implicit bias among health care professionals leads to disparities in how health care is delivered. Generations of structural racism ...
Source: Obstetrics and Gynecology - January 7, 2021 Category: OBGYN Authors: Gillispie-Bell V Tags: Obstet Gynecol Source Type: research

Expanded Carrier Screening and the Complexity of Implementation.
Abstract Advances in genetic technology have allowed for the development of multiplex panels that can test for hundreds of genetic disorders at the same time; these large panels are referred to as expanded carrier screening. This process can screen couples for far more conditions than the gene-by-gene approach used with traditional carrier screening; however, although expanded carrier screening has been promoted as an efficient means of detecting many more disorders, the complexities of genetic sequencing raise substantial challenges and concerns. In our practice, we have seen a number of complex cases in which on...
Source: Obstetrics and Gynecology - January 7, 2021 Category: OBGYN Authors: Silver J, Norton ME Tags: Obstet Gynecol Source Type: research

Association of Persistent Breech Presentation With External Cephalic Version Success.
Abstract OBJECTIVE: To evaluate a possible correlation between a new variable-persistent breech presentation-and the success rate of external cephalic version (ECV). METHODS: This was a retrospective study of ECVs performed from January 2008 through January 2019 in an Israeli tertiary care hospital. The study group included all pregnant women who underwent an ECV at or beyond 37 weeks of gestation. Persistent breech presentation was defined as persistent breech presentation during all ultrasound examinations performed between the anatomy scan at mid-pregnancy and the gestational week when ECV was attempted. W...
Source: Obstetrics and Gynecology - January 7, 2021 Category: OBGYN Authors: Lauterbach R, Bachar G, Ben-David C, Matanes E, Ginsberg Y, Beloosesky R, Ganem N, Weiner Z, Zipori Y Tags: Obstet Gynecol Source Type: research

Efficacy of Diving Reflex in Near-Term Fetal Tachycardia.
CONCLUSIONS: Cardioversion of fetal supraventricular tachycardia at term by eliciting the diving reflex could be offered to allow normal labor and vaginal delivery. PMID: 33416281 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - January 7, 2021 Category: OBGYN Authors: Papa M, Mauri L, Sandrini C, Persico N, Colli AM Tags: Obstet Gynecol Source Type: research

Reducing Maternal Morbidity and Racial Disparities in Hypertension Care Using an Automated Care Pathway.
PMID: 33416282 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - January 7, 2021 Category: OBGYN Authors: Hauspurg A Tags: Obstet Gynecol Source Type: research

Hysterotomy Extension at Cesarean Delivery and Future Uterine Rupture.
PMID: 33416283 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)
Source: Obstetrics and Gynecology - January 7, 2021 Category: OBGYN Authors: Wilkie G, Shipp TD, Little SE, Fadayomi A, Carusi DA Tags: Obstet Gynecol Source Type: research

Racial and Ethnic Disparities in Reproductive Health Services and Outcomes, 2020.
We describe relevant components of the Affordable Care Act (ACA) and the Preventing Maternal Deaths Act, which can help to further strengthen reproductive health care, close gaps in services and outcomes, and decrease racial-ethnic reproductive health disparities. Owing to continued diminishment of certain components of the ACA, to optimally reach reproductive health equity, comprehensive health insurance coverage is vital. Strengthening policy-level strategies, along with ACOG's heightened commitment to eliminating racial disparities in women's health by confronting bias and racism, can strengthen actions toward reproduct...
Source: Obstetrics and Gynecology - January 7, 2021 Category: OBGYN Authors: Sutton MY, Anachebe NF, Lee R, Skanes H Tags: Obstet Gynecol Source Type: research