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Arch Gynecol Obstet 2020 May 22. Epub 2020 May 22.

Obstetrics and Gynaecology Unit, Mauriziano Umberto I Hospital, Largo Turati 62, 10128, Turin, Italy.

Purpose: The aim of our study was to assess the outcomes of a prolonged induction carried out with a second sequential cycle of pharmacological stimulation after unsatisfactory response to a first attempt, and to highlight variables correlated with higher response rates.

Methods: A retrospective study was carried out on 157 women who underwent a two-step labor induction by vaginal prostaglandins followed by a second cycle of prostaglandins or intravenous oxytocin. Outcomes assessed were mode of delivery and maternal and neonatal morbidity. Read More

PLoS Med 2020 May 22;17(5):e1003103. Epub 2020 May 22.

Department of Midwifery Science, AVAG, Amsterdam Public Health research institute, Amsterdam UMC, location VUmc, Amsterdam, the Netherlands.

Background: Variations in intervention rates, without subsequent reductions in adverse outcomes, can indicate overuse. We studied variations in and associations between commonly used childbirth interventions and adverse outcomes, adjusted for population characteristics.

Methods And Findings: In this multinational cross-sectional study, existing data on 4,729,307 singleton births at ≥37 weeks in 2013 from Finland, Sweden, Norway, Denmark, Iceland, Ireland, England, the Netherlands, Belgium, Germany (Hesse), Malta, the United States, and Chile were used to describe variations in childbirth interventions and outcomes. Read More

Ultrasound Obstet Gynecol 2020 May 21. Epub 2020 May 21.

Department of Obstetrics and Gynecology, Baylor College of Medicine/Texas Children's Hospital.

Objective: Fetal repair of an open neural tube defect by hysterotomy has been shown to reduce the need for shunting and improve motor outcomes for infants, but increases the risk of cesarean section and prematurity. Fetoscopic repair is an alternate approach that may confer similar neurological benefits, but allows for vaginal delivery and reduces the incidence of hysterotomy related complications. We sought to compare the cost of the two approaches, from fetal surgery until neonatal discharge. Read More

Ultrasound Obstet Gynecol 2020 May 19. Epub 2020 May 19.

Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR.

Objective: To evaluate the effects of coronavirus disease 2019 (COVID-19) on maternal, perinatal and neonatal outcomes by performing a systematic review of available published literature on pregnancies affected by COVID-19.

Methods: We performed a systematic review to evaluate the effects of COVID-19 on pregnancy, perinatal and neonatal outcomes. We conducted a comprehensive literature search using PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure Database and Wan Fang Data until 20 April 2020 (studies were identified through PubMed alert after that date). Read More

J Matern Fetal Neonatal Med 2020 May 19:1-7. Epub 2020 May 19.

Department of Obstetrics and Gynecology, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.

Cesarean delivery (CD) is one of the most common operations worldwide. Vaginal birth after cesarean (VBAC) could be a solution to decrease increased CD rates. On the other hand, risks of VBAC on maternal and neonatal outcomes drifts physicians and patients to a scheduled CD. Read More

J Midwifery Womens Health 2020 May 18. Epub 2020 May 18.

Department of Midwifery, Sixteenth Street Community Health Centers, Milwaukee, Wisconsin.

Because of the high cesarean rate in the United States, perinatal care providers are increasingly called upon to counsel women considering labor after cesarean. This counseling can be more complicated for women with class 3 obesity, defined as a body mass index at or exceeding 40. Although labor after cesarean may be less likely to result in successful vaginal birth after cesarean (VBAC) for this population, the risks of repeat cesarean are also higher for these women. Read More

Arch Gynecol Obstet 2020 May 14. Epub 2020 May 14.

Department of Obstetrics and Gynecology, University Hospital Marburg, Marburg, Germany.

Purpose: To determine whether there is an association between term cesarean breech delivery in the first pregnancy and maternal and neonatal morbidities in the subsequent pregnancy and delivery.

Methods: We conducted a retrospective, nationwide Finnish population-based cohort study, including all deliveries from January 2000 to December 2017. We included all women with the first two consecutive singleton deliveries of which the first one was a breech delivery regardless of mode of delivery (n = 11,953), and constructed a data set in which the first two deliveries for these women were connected. Read More

Am J Perinatol 2020 May 13. Epub 2020 May 13.

Department of Obstetrics, Chengdu Jinjiang Maternity and Child Health Hospital, Chengdu, China.

Objective:  The aim of this study is to summarize currently available evidence on vertical transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Study Design:  A systematic review was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis Statement.

Results:  A total of 22 studies comprising 83 neonates born to mothers diagnosed with coronavirus disease 2019 were included in the present systematic review. Read More

Am J Obstet Gynecol MFM 2020 May 8:100133. Epub 2020 May 8.

Department of Obstetrics & Gynecology, Division of Maternal Fetal Medicine, NYU Langone Health.

Introduction: Since the first reports of the emergence of the novel coronavirus SARS-CoV-2 and its associated disease (COVID-19), concerns remain about whether the virus is transmissible in pregnant women from the mother to the fetus during either the antepartum period or the process of labor and delivery. One recent review reported that in a small number of cases, two PCR swabs of the placenta were sent in additional to neonatal and cord blood testing, and both placental PCR swabs were negative. Other studies have demonstrated the finding of SARS-CoV2 IgM in neonates born to mothers diagnosed with COVID-19 during pregnancy, findings that may indicate vertical transmission of the virus in utero. Read More

J Obstet Gynaecol Can 2020 May 7. Epub 2020 May 7.

Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; Department of Obstetrics and Gynaecology, St. Michael's Hospital, Toronto, ON.

Objective: To develop and implement a trial of labour after cesarean delivery (TOLAC) bundle-a group of interventions aimed at decreasing cesarean delivery (CD) for women who have had a prior CD (Robson group 5).

Methods: A TOLAC bundle was developed that included: (1) educational rounds for health care providers, (2) a physician-patient TOLAC discussion aid, and (3) patient-centred educational resources. A before-and-after study design was employed. Read More

BMJ Open Qual 2020 May;9(2)

Maternal Fetal Department, Hospital Israelita Albert Einstein, Sao Paulo, São Paulo, Brazil.

Background: Caesarean rates increased in different parts of the world, rising from 20% to 33% in the USA and from 40% to 55% in Brazil between 1996 and 2011; however, there was no reduction in morbimortality rates. Several factors have been suggested as responsible for this increase, such as health judicialisation, fear of the painful process on the patients' part and reduction of medical training in vaginal delivery and labour complications. It is urgent to reverse this process and, therefore, a model of actions was created with the intention of engaging the team in order to reduce caesarean rates in a Brazilian hospital. Read More

BMC Pregnancy Childbirth 2020 May 7;20(1):278. Epub 2020 May 7.

Chaim Sheba Medical Center, Tel HaShomer Hospital, Ramat Gan, Israel.

Background: The attendance to the gynecological-emergency-room (GER) of women only a few weeks following previous discharge after birth comprises a medical as well as social problem. The objective of the study was to characterize the postpartum women that attended the GER, and depict the leading etiologies and risk-factors that lead them to attend the GER, and to examine correlations between their medical findings at discharge and the reasons for their attendance to the hospital.

Methods: All women that attended the GER between 01/01/2016 and 30/09/2016 during 6 weeks after birth were included. Read More

Eur J Obstet Gynecol Reprod Biol 2020 Apr 30. Epub 2020 Apr 30.

Department of Obstetrics and Gynecology, Goethe University Klinikum, Frankfurt, Germany.

Introduction: The best way to deliver a term breech infant is still a much discussed topic among obstetricians. The question whether nulliparity should be considered an exclusion criterion for an intended vaginal breech delivery is not fully answered.

Objective: We compared maternal and neonatal outcome of intended vaginal breech deliveries of nulliparous versus multiparous women at term. Read More

Theriogenology 2020 Apr 21;152:18-28. Epub 2020 Apr 21.

Institute of Microbiology in Parasitology, Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia.

With recent research in humans, a hypothesis known as the sterile womb paradigm has been challenged. The objectives of this study were to determine the presence of placental and fetal microbiomes in dogs, the effect of different types of parturition on the fetal microbiome, and the effect that the fetal microbiome has on early puppy development. A total of 96 newborn puppies from 17 dams were included in the study. Read More

Best Pract Res Clin Obstet Gynaecol 2020 Apr 7. Epub 2020 Apr 7.

Effective Care Research Unit, University of the Witwatersrand/Fort Hare, Eastern Cape Department of Health, East London, South Africa.

The second stage of labor, from full cervical dilatation to complete birth of the baby or babies, constitutes the time of greatest risk for the baby. Birth attendants at all levels require training in the skills necessary to overcome difficulties that may arise unexpectedly during the second stage, particularly poor progress, shoulder dystocia, and breech birth. The mother should receive emotional support and encouragement to bear down instinctively when she feels the urge to do so, in the position she feels enables her to push most effectively, but not the supine position. Read More

Acta Obstet Gynecol Scand 2020 May 2. Epub 2020 May 2.

Department of Obstetrics and Gynecology, Leiden University Medical Centre, Leiden, the Netherlands.

Introduction: Peripartum hysterectomy is a surgical procedure performed for severe obstetric complications such as major obstetric hemorrhage. The prevalence of peripartum hysterectomy in high-resource settings is relatively low. Hence, international comparisons and studying indications and associations with mode of birth rely on the use of national obstetric survey data. Read More

In Vivo 2020 May-Jun;34(3):1195-1200

Department of Obstetrics and Gynecology, Erlangen University Hospital, Erlangen, Germany

Background/aim: Even though vaginal delivery is a feasible option in patients with preeclampsia, the cesarean section rate in those patients is high. The aim of this study was to evaluate the influence of preeclampsia on induction of labor at term.

Patients And Methods: This historical cohort study analyzed inductions of labor in women at term having preeclampsia versus women who were induced due to other reasons. Read More

J Midwifery Womens Health 2020 Apr 30. Epub 2020 Apr 30.

Yale School of Nursing, Yale University, New Haven, Connecticut.

Introduction: The purpose of this integrative review was to synthesize the literature on women's perceived barriers and facilitators to achieving a vaginal birth after cesarean.

Methods: A search of Scopus and PubMed databases and relevant citations from 2000 to 2018 was conducted to identify resources meeting inclusion criteria. Conclusion drawing and verification were completed using data displays, data analysis, and comparison. Read More

MedEdPORTAL 2020 Mar 20;16:10891. Epub 2020 Mar 20.

Assistant Dean for Medical Education and Academic Affairs, Florida Atlantic University Charles E. Schmidt College of Medicine.

Introduction: Although shared decision making (SDM) is optimal for trial of labor after cesarean (TOLAC) counseling, resources to assess residents' clinical competency and communication skills are lacking. We addressed this gap by developing and testing an objective structured clinical examination (OSCE) to evaluate whether learners were able to use SDM in TOLAC counseling.

Methods: We created three simulation scenarios with increasing complexity to assess the skills of residents in their first, second, or third postgraduate year in using SDM in TOLAC counseling. Read More

BMC Pregnancy Childbirth 2020 Apr 25;20(1):248. Epub 2020 Apr 25.

Department of Obstetrics and Gynecology, Sapporo Medical University, S1, W16, Chuou-ku, Sapporo, Hokkaido, 0608543, Japan.

Background: Radical tracheletomy (RT) with pelvic lymphadenectomy has become an option for young patients with early invasive uterine cervical cancer who desire to maintain their fertility. However, this operative method entails a high risk for the following pregnancy due to its radicality.

Methods: We have performed vaginal RT for 71 patients and have experienced 28 pregnancies in 21 patients. Read More

Rev Bras Ginecol Obstet 2020 Apr 24;42(4):181-187. Epub 2020 Apr 24.

Maternal Fetal Medicine Service, Maternidade Assis Chateaubriand, Universidade Federal do Ceará, Fortaleza, CE, Brazil.

Objective:  To evaluate the ability of the pubic arch angle (PAA) as measured by transperineal ultrasonography during labor to predict the delivery type and cephalic pole disengagement mode.

Methods:  The present prospective cross-sectional study included 221 women in singleton-gestational labor ≥ 37 weeks with cephalic fetuses who underwent PAA measurement using transperineal ultrasonography. These measurements were correlated with the delivery type, cephalic pole disengagement mode, and fetal and maternal characteristics. Read More

JAMA Netw Open 2020 Apr 1;3(4):e203076. Epub 2020 Apr 1.

Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, Pennsylvania.

Importance: More than 20% of births globally are by cesarean delivery, including more than 30% in the US. Prior studies have reported lower rates of childbearing after cesarean delivery, but it is not clear if this is due to maternal choice or lower conception rates.

Objective: To investigate the association between mode of first delivery and subsequent conceptions and live births. Read More

AJP Rep 2020 Apr 15;10(2):e148-e154. Epub 2020 Apr 15.

Department of Maternal-Fetal Medicine, Adventist Health White Memorial Medical Center, Los Angeles, California.

 The Maternal-Fetal Medicine Units (MFMU) Network developed a prediction model for calculating the likelihood of successful vaginal birth after cesarean (VBAC) in patients undergoing a trial of labor after cesarean (TOLAC). In this prediction model, Latina ethnicity is considered a negative predictive factor for successful VBAC. Subsequent studies have found mixed results regarding VBAC success in Latina ethnicity. Read More

J Perinat Educ 2020 Apr;29(2):72-82

Second-stage labor is the most challenging stage of labor, as it requires increasing exertion of the birthing woman. Variances in nursing interventions in second-stage labor have an influence on outcomes. There is disparity in nursing care during second-stage labor. Read More

Acta Neurochir (Wien) 2020 Apr 18. Epub 2020 Apr 18.

Department of Surgery, Division of Neurosurgery, DeGroote Medical School, McMaster University, Hamilton, ON, Canada.

Background: The optimal management of Chiari I malformation during pregnancy remains uncertain. Labor contractions, which increase intracranial pressure, and neuraxial anesthesia both carry the theoretical risk of brainstem herniation given the altered CSF dynamics inherent to the condition. Mode of delivery and planned anesthesia, therefore, require forethought to avoid potentially life-threatening complications. Read More

Ital J Pediatr 2020 Apr 15;46(1):45. Epub 2020 Apr 15.

Dietetics and Clinical Nutrition Laboratory - Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Bassi 21, 27100, Pavia, Italy.

Background: Fetal programming during in utero life defines the set point of physiological and metabolic responses that lead into adulthood; events happening in "the first 1,000 days" (from conception to 2-years of age), play a role in the development of non-communicable diseases (NCDs). The infant gut microbiome is a highly dynamic organ, which is sensitive to maternal and environmental factors and is one of the elements driving intergenerational NCDs' transmission. The A. Read More

BMC Pregnancy Childbirth 2020 Mar 23;20(1):181. Epub 2020 Mar 23.

Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, India.

Background: This paper discusses length of stay (LOS) following childbirth as an indicator of quality of postnatal care in health institutions. This research aims to describe LOS according to both vaginal and cesarean deliveries in public and private health care institutions in India, and to identify any association of LOS with postnatal care and post-delivery complications.

Methods: We use recently released nationally-representative data from the National Family Health Survey-4 (2015-16) and apply the Cox proportional hazard model to determine the factors associated with LOS at the health facility after childbirth during a five-year period preceding the survey. Read More

Pak J Med Sci 2020 Mar-Apr;36(3):550-554

Xuemei Li Department of Cardiovascular, Binzhou Shili Hospital, Binzhou, 256617, China.

Objective: To analyze the clinical effect of delivery ball and free position delivery nursing in primipara delivery.

Methods: Total 110 primipara who were admitted to the department of gynecology and obstetrics of our hospital from August 2017 to August 2018 were included in the study. They were randomly divided into an observation group and a control group, 55 each group. Read More

Obstet Gynecol 2020 May;135(5):1015-1023

Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, the Department of Obstetrics and Gynecology, Robert Debré Hospital, APHP, and Port-Royal maternity unit, Cochin Hospital, APHP, Paris, the Department of Gynecology-Obstetric and Reproductive Medicine, Hôpital La Conception/Hôpital Nord, AP-HM, and Aix Marseille Univ, UM 63, CNRS 7278, IRD 198, INSERM 1095, Marseille, Inserm, UMR1027, Equipe SPHERE, the Université de Toulouse III, UMR1027, and CHU Toulouse, Pôle de gynécologie obstétrique, Hôpital Paule de Viguier, Toulouse, the Obstetrical Care Unit, Hôpital Couple Enfant, Grenoble University Hospital, CS 10217, 38043, Grenoble, the Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux, and the Department of Obstetrics and Gynecology, CHU de Rouen, Université de Rouen, Rouen, France.

Objective: To compare neonatal mortality and morbidity of first twins according to the planned mode of delivery when the first twin is in breech presentation, in a country where planned vaginal delivery is an option.

Methods: This is a planned secondary analysis of the JUMODA (JUmeaux MODe d'Accouchement) cohort, a national prospective population-based study of twin deliveries conducted in 176 French hospitals. We analyzed pregnancies with first twins in breech presentation and applied the inclusion criteria of the Twin Birth Study (except the criterion for first-twin presentation): both fetuses alive, with a birth weight between 1,500 g and 4,000 g, at or after 32 0/7 weeks of gestation. Read More

JAMA Netw Open 2020 Apr 1;3(4):e202605. Epub 2020 Apr 1.

Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.

Importance: Cesarean delivery is associated with an increased risk of childhood obesity in offspring. However, whether this increased risk also includes obesity-associated conditions remains unclear.

Objective: To evaluate the association of birth by cesarean delivery with offspring's risks of obesity and type 2 diabetes in adulthood. Read More

JAMA Netw Open 2020 Apr 1;3(4):e202280. Epub 2020 Apr 1.

Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester.

Importance: On October 1, 2015, the US transitioned to the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for recording diagnoses, symptoms, and procedures. It is unknown whether this transition was associated with changes in diagnostic category prevalence based on diagnosis classification systems commonly used for payment and quality reporting.

Objective: To assess changes in diagnostic category prevalence associated with the ICD-10-CM transition. Read More

Acta Obstet Gynecol Scand 2020 Apr 6. Epub 2020 Apr 6.

Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Introduction: The association between the mode of previous delivery and subsequent success of assisted reproductive treatment has been poorly understood. By mitigating the detrimental effect of supraphysiologic estradiol levels on endometrial receptivity, a freeze-all strategy provides a novel model to investigate the sole impact of a prior cesarean delivery (CD) on embryo transfer outcomes.

Material And Methods: This single-center retrospective cohort study included 2660 patients who underwent their first frozen-thawed embryo transfer cycles after a freeze-all policy from January 2013 to December 2018. Read More

Eur J Obstet Gynecol Reprod Biol 2020 Mar 25. Epub 2020 Mar 25.

Service de gynécologie-obstétrique, CHU de Rouen, Université de Rouen, France.

Objective: To determine the optimal management of singleton fetuses in breech presentation.

Materials And Methods: Consultation of the PubMed database, the Cochrane Library and guidelines issued by the French and foreign obstetrical societies or colleges.

Results: In France, 5% of women have breech deliveries (level of evidence [LE] 3). Read More

Eur J Obstet Gynecol Reprod Biol 2020 May 6;248:150-155. Epub 2020 Mar 6.

Department of Obstetrics, Leiden University Medical Centre, the Netherlands.

Objective: Maternal heart disease (HD) complicates 1-4 % of pregnancies and is associated with adverse maternal and fetal outcomes. Although vaginal birth is generally recommended in the guidelines, cesarean section (CS) rates in women with HD are often high. Aim of the present study was to evaluate mode of birth and pregnancy outcomes in women with HD in a tertiary care hospital in the Netherlands. Read More

Minerva Pediatr 2020 04 2. Epub 2020 Apr 2.

Department of Obstetrics and Gynecology, Postgraduate Student 3rd Year, Institute of Medical Sciences and Research, Andhra Pradesh, India.

Background: Fetal gender is considered as one of significant predictors of pregnancy and perinatal outcome. Aim - To assess impact of fetal gender on perinatal outcome.

Methods: Present observational study was conducted in Obstetrics and Gynecology department of rural tertiary center of Northern India over one year (January-December 2018) on all randomly selected antenatal women at gestation ≥28 weeks, delivering by any route (Cesarean/Vaginal) and fulfilling inclusion criteria were enrolled. Read More

Am J Obstet Gynecol 2020 Mar 23. Epub 2020 Mar 23.

School of Nursing, Women's Studies Department, University of Michigan, Ann Arbor, MI.

Objective: To evaluate the association between opioid prescribing during pregnancy and new persistent opioid use in the year following delivery.

Materials And Methods: This nationwide retrospective cohort study included patients aged 12-55 years in Optum's deidentified Clinformatics Data Mart Database who were undergoing vaginal delivery or cesarean delivery from 2008 to 2016, with continuous enrollment from 2 years before birth to 1 year postdischarge. Women were included if they were opioid naive in pregnancy (ie, did not fill an opioid prescription 2 years to 9 months before delivery) and did not undergo a procedure within the year after discharge. Read More

BMC Pregnancy Childbirth 2020 Mar 24;20(1):170. Epub 2020 Mar 24.

Department of Obstetrics, Perinatal Medical Center, TOYOTA Memorial Hospital, 1-1, Heiwa-cho, Toyota, Aichi, Japan.

Background: Cesarean delivery rates are increasing globally with almost half of them occurring due to a previous Cesarean delivery. A trial of labor after Cesarean (TOLAC) is considered a safe procedure, but most eligible women instead undergo Cesarean before 39 weeks of gestation. Lack of education about TOLAC is often associated with increased repeat Cesarean. Read More

Acta Obstet Gynecol Scand 2020 Mar 20. Epub 2020 Mar 20.

Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Introduction: The proof-of-concept of uterus transplantation, as a treatment for absolute uterine factor infertility, came with the first live birth after uterus transplantation, which took place in Sweden in 2014. This was after a live donor procedure, with laparotomy in both donor and recipient. In our second, ongoing trial we introduced a robotic-assisted laparoscopic surgery of the donor to develop minimal invasive surgery for this procedure. Read More

Sci Rep 2020 Mar 18;10(1):4944. Epub 2020 Mar 18.

Université de Paris, Epidemiology and Statistics research Center/CRESS, INSERM, INRA, F-75004, Paris, France.

Planned vaginal delivery in twin pregnancies has three potential outcomes: vaginal or cesarean delivery of both twins, or cesarean for the second twin. Our objective was to assess the association between delivery mode and severe acute maternal morbidity (SAMM) in women with twin pregnancies and planned vaginal deliveries. We limited this planned secondary analysis of the JUMODA cohort, a national prospective population-based study of twin deliveries, to women with planned vaginal delivery at or after 24 weeks of gestation who gave birth to two live fetuses at hospital. Read More

Ultrasound Obstet Gynecol 2020 05;55(5):586-592

The Royal College of Obstetricians and Gynaecologists, London, UK.

Objectives: There are limited case series reporting the impact on women affected by coronavirus during pregnancy. In women affected by severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), the case fatality rate appears higher in those affected in pregnancy compared with non-pregnant women. We conducted a rapid review to guide health policy and management of women affected by COVID-19 during pregnancy, which was used to develop the Royal College of Obstetricians and Gynaecologists' (RCOG) guidelines on COVID-19 infection in pregnancy. Read More

Am J Obstet Gynecol 2020 Mar 7. Epub 2020 Mar 7.

Digestive Disease and Surgery Institute, Cleveland Clinic.

Uterus transplantation is the only known potential treatment for absolute uterine factor infertility. It offers a unique setting for the investigation of immunologic adaptations of pregnancy in the context of the pharmacologic-induced tolerance of solid organ transplants, thus providing valuable insights into the early maternal-fetal interface. Until recently, all live births resulting from uterus transplantation involved living donors, with only 1 prior birth from a deceased donor. Read More

PLoS One 2020 6;15(3):e0229304. Epub 2020 Mar 6.

Clinical Epidemiology Division, Department of Medicine, Karolinska University Hospital and Institutet, Stockholm, Sweden.

Background: To improve care for women going through trial of labor after cesarean (TOLAC), we need to understand their birth experience better. We investigated the association between mode of delivery on birth experience in second birth among women with a first cesarean.

Methods: A population-based cohort study based on the Swedish Pregnancy Register with 808 women with a first cesarean and eligible for TOLAC in 2014-2017. Read More

AJP Rep 2020 Jan 4;10(1):e37-e41. Epub 2020 Mar 4.

Division of Maternal Fetal Medicine, Department of OBGYN, Duke University, Durham, North Carolina.

 The study aims to reduce cesarean rates, eligible women are being offered an option of vaginal birth after cesarean (VBAC). However, little data exist regarding efficacy of amniotomy as a tool in this population. We sought to evaluate the impact of early amniotomy on VBAC success. Read More

Arch Gynecol Obstet 2020 Apr 3;301(4):941-948. Epub 2020 Mar 3.

Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, POB 12000, 91120, Jerusalem, Israel.

Purpose: Currently there are no existing data regarding the maternal and neonatal outcomes for nulliparous women delivering neonates with birthweight above 4500 g. We aim to evaluate birth outcome among these subset of parturients.

Methods: A retrospective study of nulliparous delivering a singleton fetus weighing  ≥ 4500 g in two tertiary medical centers between 2007 and 2018. Read More

Eur J Obstet Gynecol Reprod Biol 2020 Apr 27;247:143-148. Epub 2020 Jan 27.

Fetal Medicine Department, Corniche Hospital, Abu Dhabi, United Arab Emirates. Electronic address:

Title: Outcome of multiple cesarean sections in a tertiary maternity hospital in the United Arab Emirates.

Objective: To describe the operative outcomes, clinical findings, maternal morbidity and neonatal outcome associated with increasing numbers of cesarean deliveries.

Design: Retrospective study. Read More

J Matern Fetal Neonatal Med 2020 Feb 27:1-5. Epub 2020 Feb 27.

Departments of Fetal Maternal Medicine, National Nagara Medical Center, Gifu, Japan.

Although amnioinfusion (AI) for repetitive variable deceleration has been reported to reduce the frequency of variable deceleration and cesarean section (CS) rate, CS is sometimes unavoidable even after therapeutic AI. The purpose of this study was to investigate prenatal factors related to the efficacy of therapeutic AI during labor. This retrospective study investigated 80 singleton pregnancies that underwent transcervical therapeutic AI for repetitive variable deceleration during labor. Read More

J Pediatr Adolesc Gynecol 2020 Feb 19. Epub 2020 Feb 19.

Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

Study Objective: Data regarding trial of labor after cesarean delivery (TOLAC) among young women are limited. The aim of this study was to assess the TOLAC success rate and its related factors among adolescent women who had never delivered vaginally.

Design: A multicenter retrospective cohort study of all adolescent women aged ≤21 years with a history of 1 previous cesarean delivery, who delivered in 2 tertiary medical centers during 2007-2019. Read More

Int Urogynecol J 2020 Feb 15. Epub 2020 Feb 15.

Physical Therapy Post-Graduate Program, Federal University of São Carlos (UFSCar), Rodovia Washington Luis, km 235, São Paulo, CEP 13565-905, Brazil.

Introduction And Hypothesis: The literature presents controversial results regarding the role of delivery mode in pelvic floor muscle (PFM) function after birth. Some studies showed a greater impairment of PFM function after vaginal delivery compared with cesarean section, while others have not identified a significant difference between these two modes of delivery. This study aimed to investigate whether there was a difference in short-term PFM function after childbirth in primiparous women who underwent cesarean section compared with those who underwent vaginal delivery. Read More

Mayo Clin Proc Innov Qual Outcomes 2020 Feb 20;4(1):3-7. Epub 2019 Dec 20.

Department of Obstetrics and Gynecology, Mayo Clinic Health System-Franciscan Healthcare, La Crosse, WI.

Since the introduction of a hospitalist physician model of care by Wachter and Goldman in 1996, important changes have occurred to address the care of hospitalized patients. This model was followed by the introduction of laborist physicians by Louis Weinstein in 2003, although large health maintenance organization practices have used this model since the 1990s. The American Congress of Obstetricians and Gynecologists supported the laborist model in a 2016 statement that was reaffirmed in 2017, recommending "the continued development and study of the obstetric and gynecologic hospitalist model as one potential approach to improve patient safety and professional satisfaction across delivery settings. Read More

Birth 2020 Jun 12;47(2):237-245. Epub 2020 Feb 12.

Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.

Introduction: Various biopsychosocial factors affect women's preferences with respect to mode of birth, but they are usually not examined simultaneously and prospectively. In the current study, we assessed the contribution of personal characteristics of first-time mothers, their prior prenatal perceptions, events during birth, and subjective birth experiences, on their preference about mode of second birth.

Methods: This was a secondary analysis of two prospective birth cohort studies. Read More