Maternal-fetal medicine fellow experience in the first year of training compared to interview expectations based on interview modality.

Background: Virtual interviews for Maternal-Fetal Medicine (MFM) fellowship have been feasible and successful with significant cost and time savings. However, there are concerns about an applicant's ability to accurately evaluate a program virtually. The objective of this study was to evaluate MFM fellows' experience in their fellowship training program at the completion of their first year compared to their expectations of the program based on their interview, comparing fellows who interviewed in-person to those who interviewed virtually.

Association between interpreter use and small for gestational age infants.

Background: Limited English proficiency is associated with worse health outcomes regardless of health literacy. Prior research suggests that using interpreter services for low English proficiency helps mitigate the language barrier, is associated with improved health outcomes, and patient satisfaction; however, obstetric and neonatal outcomes and pregnancy risks in this population are not well studied.

Objectives: The primary purpose of this study was to determine if low English proficiency is an independent risk factor for small for gestational age infants by utilizing interpreter use as a proxy for low English proficiency.

Maternal-fetal medicine fellowship program director perspective on virtual interviews following matriculation of the first virtual interview class.

Background: The first class of virtually interviewed maternal-fetal medicine fellows has matriculated into their training programs.

Objective: This study aimed to evaluate the impact of virtual interviews on the outcomes of the National Resident Matching Program within our subspecialty. We assessed maternal-fetal medicine fellowship program directors' experience with their fellows who interviewed virtually as compared with experience with the previous year's fellows who interviewed in-person.

Metformin Exposure and Risk of Hypertensive Disorders of Pregnancy in Patients with Type 2 Diabetes.

Objective: Metformin has been found to have a role in promoting vascular remodeling and angiogenesis which may reduce the risk of developing preeclampsia. Prior studies have shown a decrease in the incidence of hypertensive disorders of pregnancy in patients with type 2 and gestational diabetes taking metformin. We hypothesize metformin exposure decreases the risk of developing hypertension in patients with type 2 diabetes.

Maternal-fetal medicine program director experience of exclusive virtual interviewing during the coronavirus disease 2019 pandemic.

Background: The coronavirus disease 2019 pandemic necessitated an abrupt transition to exclusive virtual interviewing for maternal-fetal medicine fellowship programs.

Objective: This study aimed to assess the maternal-fetal medicine fellowship program directors' approaches to exclusive virtual interviews and to obtain program director feedback on the virtual interview experience to guide future interview cycles.

Study Design: A novel cross-sectional online survey was distributed through the Society for Maternal-Fetal Medicine to program directors after the completion of the interview season, but before the results of the National Resident Matching Program on October 14, 2020.

Effect of virtual interviewing on applicant approach to and perspective of the Maternal-Fetal Medicine Subspecialty Fellowship Match.

Background: The 2020 application cycle for the Maternal-Fetal Medicine Specialty Fellowship Match was the first to be exclusively virtual.

Objective: Our study was designed to compare approaches and perspectives of the MFM fellowship candidates who applied with virtual interviews with those of the current Maternal-Fetal Medicine fellows, who applied with in-person interviews in 2017, 2018, or 2019.

Study Design: A survey was developed by the Society for Maternal-Fetal Medicine Fellowship Affairs Committee to ascertain applicant approaches to and perspectives of the Maternal-Fetal Medicine Fellowship Match and was disseminated after 2020 Maternal-Fetal Medicine interviews ended and completed before Fellowship Match Day.

A Matter of Time: Does Gestational Age Affect the Duration of the Fetal Anatomic Survey?

Objective: To assess the average duration of detailed fetal anatomic surveys in pregnancy in relation to gestational age (GA) and the maternal body mass index (BMI) to determine optimal timing of the examination.

Methods: This was a retrospective cohort study of gravidae presenting for detailed fetal anatomic examinations between January 1, 2010, and June 30, 2017. After excluding examinations expected to have longer duration (ie, multifetal, major fetal anomalies), there were a total of 6522 examinations performed between GAs of 18 weeks 0 days and 22 weeks 0 days.

Prostaglandins and cesarean delivery for nonreassuring fetal status in patients delivering small-for-gestational age neonates at term.

Growth-restricted fetuses have been excluded from many randomized trials of prostaglandins for labor induction. As prostaglandins, particularly misoprostol, are associated with increased rates of cesarean delivery for nonreassuring fetal heart tracing, it is important to assess their safety in pregnancies at higher risk of this complication. The objective of this study was to estimate the association between use of prostaglandins for labor induction in term singleton pregnancies complicated by delivery of small-for-gestational age (SGA) neonates and the risk of cesarean delivery for nonreassuring fetal status (NRFS).

Effect of Oligohydramnios on Fetal Heart Rate Patterns during Term Labor Induction.

Objective: To estimate the effect of oligohydramnios on fetal heart rate (FHR) patterns in patients undergoing induction of labor (IOL) at term.

Study Design: Secondary analysis of a prospective cohort study of consecutive term, singleton deliveries from 2010 to 2015. We included all patients who underwent IOL.

Implementation and Outcomes of Universal Delayed Umbilical Cord Clamping at Term.

Objective: To evaluate the implementation of an institutional protocol for universal delayed umbilical cord clamping (DCC) at term on maternal, neonatal, and umbilical cord blood gas outcomes.

Study Design: This is a retrospective cohort study of singleton term gestations from April through July 2017. On June 1, 2017, a protocol was implemented for DCC in all deliveries.

Effect of a Home-Based Lifestyle Intervention on Breastfeeding Initiation Among Socioeconomically Disadvantaged African American Women with Overweight or Obesity.

Background: Socioeconomically disadvantaged (SED) African American women with overweight or obesity are less likely to breastfeed.

Objective: To test whether a home-based lifestyle intervention impacts breastfeeding initiation rates in SED African American women with overweight or obesity.

Study Design: This was a secondary analysis of a randomized controlled trial from October 2012 to March 2016 at a university-based hospital within the LIFE-Moms consortium.

Normal Cervical Effacement in Term Labor.

Objective: To estimate the natural history of cervical effacement in labor.

Study Design: This is a retrospective cohort study of term, vertex, singletons who reached 10 cm of cervical dilation from 2010 to 2014. Interval-censored regression was used to estimate the median number of hours between changes in effacement (measured in centimeters of the residual cervix) and to estimate the median effacement at a given cervical dilation.

Defining and Managing Normal and Abnormal First Stage of Labor.

Modern data have redefined the normal first stage of labor. Key differences include that the latent phase of labor is much slower than was previously thought and the transition from latent to active labor does not occur until about 6 cm of cervical dilatation, regardless of parity or whether labor was spontaneous or induced. Providers should have a low threshold to use one of the safe and effective interventions to manage abnormal progression in the first stage of labor, including oxytocin, internal tocodynamometry, and amniotomy.

Delayed Umbilical Cord Clamping at <32 Weeks' Gestation: Implementation and Outcomes.

Objectives: This study aims to evaluate the implementation of a delayed umbilical cord clamping (DCC) protocol for neonates <32 weeks. Secondarily, to evaluate the impact of DCC on maternal outcomes and on the ability to obtain umbilical cord blood gases.

Study Design: Retrospective cohort study from November 2014 to March 2016 of patients delivered by 31 weeks.

Delivery Outcomes after Term Induction of Labor in Small-for-Gestational Age Fetuses.

 The objective of this study was to estimate the delivery outcomes after induction of labor (IOL) at term in patients with small-for-gestational age (SGA) fetuses.  A secondary analysis of a prospective cohort study of all term, singleton deliveries from 2010 to 2014. Patients who underwent an IOL for any indication were included.

Can Transabdominal Cervical Length Measurement Exclude Short Cervix?

Objective: This study aims to determine if transabdominal (TA) cervical length may be used to rule out a short cervix on transvaginal (TV) ultrasound.

Study Design: We conducted a prospective cohort study of women undergoing routine anatomic survey at 17 to 23 weeks gestation. TA and TV cervical length measurements were obtained in each patient.