Hemoglobin A1c as a Substitute for Oral Glucose Testing in Early Pregnancy Screening.

Objective: Current recommendations for individuals with risk factors for gestational diabetes mellitus (GDM) call for screening in early pregnancy. However, there is currently no clear consensus on a specific screening modality. This study evaluates whether a hemoglobin A1c (HbA1c) screening in individuals with risk factors for gestational diabetes (GDM) could be used instead of an early 1-hour glucose challenge test (GCT).

Class III obesity is an independent risk factor for unsuccessful induction of labor.

Background: Although obesity is a known risk factor for cesarean delivery, there is a paucity of data on the course of induction of labor in these patients.

Objective: With emerging data on the safety of 39-week inductions, we aimed to: (1) determine if Class III obesity, including morbid obesity, is an independent risk factor for nonachievement of complete dilation and vaginal delivery after induction of labor, (2) evaluate the characteristics of the induction of labor course and immediate complications, and (3) evaluate the number of induction agents necessary to be associated with vaginal deliveries. We hypothesized that as body mass index increased, it would take longer to achieve complete cervical dilation, more induction agents would be required, and there would be a higher rate of cesarean delivery.

Real-world implementation of a vaginal preparation policy prior to cesarean delivery.

Objective: Surgical site infections (SSIs) are a major source of morbidity and mortality for women who undergo cesarean section (c-section). SSIs following c-section include wound infection, infection of the endometrium (endometritis) and intra-abdominal infections. Perioperative interventions to prevent these infections continue to be studied, including the use of vaginal preparation prior to c-section.

Clinical Outcomes of Pregnant and Postpartum Extracorporeal Membrane Oxygenation Patients.

Background: The use of extracorporeal membrane oxygenation (ECMO) as a rescue therapy for cardiopulmonary failure is expanding in critical care medicine. In this case series, we describe the clinical outcomes of 21 consecutive pregnant or postpartum patients that required venovenous (VV) or venoarterial (VA) ECMO. Our objective was to characterize maternal and fetal survival in peripartum ECMO and better understand ECMO-related complications that occur in this unique patient population.

Leveraging Technology to Improve Diabetes Care in Pregnancy.

Pregnant women with diabetes are at higher risk of adverse outcomes. Prevention of such outcomes depends on strict glycemic control, which is difficult to achieve and maintain. A variety of technologies exist to aid in diabetes management for nonpregnant patients.

The role of fetal growth restriction in the association between Down syndrome and perinatal mortality.

Down syndrome (DS) is associated with significant risk of perinatal mortality. We hypothesize that this association is primarily mediated through the effects of fetal growth restriction (FGR). This was a retrospective cohort analysis using the US Natality Database from 2011 to 2013.

Platelets in preeclamptic pregnancies fail to exhibit the decrease in mitochondrial oxygen consumption rate seen in normal pregnancies.

Cellular oxygen consumption and lactate production rates have been measured in both placental and myometrial cells to study obstetrics-related disease states such as preeclampsia. Platelet metabolic alterations indicate systemic bioenergetic changes that can be useful as disease biomarkers. We tested the hypothesis that platelet mitochondria display functional alterations in preeclampsia.

Adverse perinatal outcomes associated with trial of labor after cesarean section at term in pregnancies complicated by maternal obesity.

Introduction: Obesity is associated with higher risks for intrapartum complications. Therefore, we sought to determine if trial of labor after cesarean section (TOLAC) will lead to higher maternal and neonatal complications compared to repeat cesarean section (RCD).

Methods: This was a retrospective cohort analysis of singleton nonanomalous births between 37 and 42 weeks GA complicated by maternal obesity (body mass index (BMI) ≥ 30 kg/m) and history of one or two previous cesarean deliveries.

Liver lacerations as a complication of CPR during pregnancy.

Aim: Cardiac arrest in peripartum patients is a rare but devastating event; reported rates in the literature range from 0.019% to 0.0085%.

Association of Maternal Obesity With Maternal and Neonatal Outcomes in Cases of Uterine Rupture.

Objective: To describe the risk of adverse outcomes associated with uterine rupture in the setting of maternal obesity.

Methods: This was a retrospective cohort analysis of singleton nonanomalous neonates born after uterine rupture between 34 and 42 weeks of gestation. We derived data from the U.