Showing papers in "Obstetrics & Gynecology in 2020"

TL;DR: With data from early in the pandemic, it is reassuring that there are low rates of maternal and neonatal mortality and vertical transmission with SARS-CoV-2.

TL;DR: Telehealth interventions were associated with improvements in obstetric outcomes, perinatal smoking cessation, breastfeeding, early access to medical abortion services, and schedule optimization for high-risk obstetrics.

TL;DR: Empirical studies provide evidence for the role of race and ethnicity, insurance, and education in pregnancy-related mortality and severe maternal morbidity risk, although many other important social determinants remain to be studied in greater depth.

TL;DR: During the first month of the SARS-CoV-2 outbreak in New York City and with evolving testing criteria, most women with laboratory-confirmed infection admitted for delivery did not have symptoms of COVID-19, and disease severity was associated with higher rates of cesarean and preterm birth.

TL;DR: In this prospective multicenter cohort study of pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, one in five women hospitalized with COVID-19 infection delivered urgently for respiratory compromise or were admitted to the ICU.

TL;DR: One of seven neonates born to women with symptomatic coronavirus 2019 (COVID-19) infection tested positive for the infection and was asymptomatic.

TL;DR: Barriers to clinical care and research participation unique to transgender and gender nonbinary people are described and concrete suggestions for creating more inclusive environments are offered.

TL;DR: An expanded obstetric comorbidity score that can be applied consistently across contemporary U.S. patient discharge data sets is developed and validated to improve comparisons of severe maternal morbidity rates across patient populations with different comor bidity case mixes.

TL;DR: As coronavirus disease 2019 (COVID-19) rapidly spreads, obstetricians must keep up to date on the latest information; although guidelines for pregnant women have been rapidly developed, many questions remain.

TL;DR: The physician should initiate an evaluation for secondary dysmenorrhea if the patient does not report improved symptomatology after being compliant with their medical regimen, and extremely effective empiric therapies are nonsteroidal antiinflammatory drugs and contraceptive hormonal therapy.

TL;DR: One in five pregnant women who contracted COVID-19 infection developed moderate or severe disease, including a small proportion with prolonged critical illness who received ICU or step-down-level care.

TL;DR: Coronavirus disease 2019 (COVID-19) has a prolonged course in ambulatory pregnant patients and needs further investigation to determine its prognosis.

TL;DR: Postpartum hemorrhage on labor admission can be predicted with excellent discriminative ability using machine learning and statistical models, and the extreme gradient boosting model provided the greatest net benefit.

TL;DR: Within hospitals in New York City, black and Latina women are at higher risk of severe maternal morbidity than white women; this is not associated with differences in types of insurance.

TL;DR: An algorithm for prone positioning of both intubated and nonintubated pregnant women is developed to address the need for low-cost, low-harm interventions in the face of a widespread viral syndrome wherein hypoxemia predominates.

TL;DR: Resources are available for remote laparoscopic and basic surgical training, including core skills, psychomotor, visual–spatial, and cognitive, to improve gaps in surgical training during the coronavirus disease 2019 (COVID-19) pandemic.

TL;DR: The findings refute the existence of a clinically significant BP drop from 12 weeks of gestation, and present widely relevant, gestation-specific reference ranges for detecting abnormal BP, heart rate, respiratory rate, oxygen saturation and temperature during pregnancy.

TL;DR: Indigenous women are at increased risk for severe maternal morbidity and mortality, particularly those who live in rural areas, according to the World Health Organization.

TL;DR: It is argued that placenta accreta spectrum exists as a Disorder of defective decidua and uterine scar dehiscence, not as a disorder of destructive trophoblast invasion.

TL;DR: Understanding whether pregnant women may be at risk for adverse maternal and neonatal outcomes from severe coronavirus infections is imperative and data from case reports of SARS-CoV, MERS- coV, and SAR-coV-2 infections during pregnancy are limited, but they may guide early public health actions and clinical decision-making for COVID-19 until more rigorous and systematically collected data are available.

TL;DR: High-dose nitric oxide is a novel treatment associated with improved oxygenation and decreased tachypnea in pregnant patients with severe coronavirus disease 2019 (COVID-19).

TL;DR: The effects of early menopause are examined and the critical role of hormone therapy in this population is highlighted, and many clinicians and women remain reluctant to use hormone therapy because of the Women's Health Initiative's adverse findings.

TL;DR: As physician-leaders enact new policies to respond to the COVID-19 public health crisis, it is important to consider the potential for exacerbating existing health inequities and to be proactive in creating policies that promote equity.

TL;DR: Adjuvant HPV vaccination in the setting of surgical excision for CIN 2 or greater is associated with a reduced risk of recurrent cervical dysplasia overall and a reduction in therisk of recurrent lesions caused by the most oncogenic strains (HPV 16,18).

TL;DR: Increased demand for self-managed medication abortion in states with in-clinic restrictions or high infection rates during the coronavirus disease 2019 (COVID-19) pandemic demonstrates the need for remote abortion care models.

TL;DR: A pregnant patient with COVID-19 infection can experience a rapid onset of critical complications that may prove fatal, despite an indolent presentation, despite aggressive supportive care and investigational therapies.

TL;DR: In this article, the authors summarize the current evidence supporting steroid therapy in the management of patients with acute respiratory distress syndrome and COVID-19 and elaborate on key modifications for the pregnant patient.

TL;DR: The case of a patient at 28 weeks of gestation with acute respiratory distress syndrome (ARDS) from COVID-19 infection, whose deteriorating respiratory condition prompted delivery, who required prolonged mechanical ventilation until postpartum day 10.

TL;DR: Current prenatal and postpartum care delivery does not match patients' preferences for visit number or between-visit contact, and patients are open to alternative models of prenatal care, including remote monitoring.

TL;DR: Audio-only virtual prenatal visits have specific and distinct advantages compared with video-enabled telehealth in a vulnerable population of women and offer a viable option to increase access to care.