Subcutaneous Tissue: To Suture or Not to Suture at Cesarean Section

Objective: The null hypothesis for this investigation was that there was no difference in the frequency of wound disruption between women who had their subcutaneous tissues approximated with suture and those who did not during cesarean section

Prediction of Spontaneous Preterm Birth Among Nulliparous Women With a Short Cervix

To evaluate whether demographic and sonographic factors associated with spontaneous preterm birth (sPTB) among nulliparous women with a cervical length (CL) < 30 mm could be combined into an accurate prediction model for sPTB

Haptoglobin Phenotype, Preeclampsia Risk and the Efficacy of Vitamin C and E Supplementation to Prevent Preeclampsia in a Racially Diverse Population

Haptoglobin's (Hp) antioxidant and pro-angiogenic properties differ between the 1-1, 2-1, and 2-2 phenotypes. Hp phenotype affects cardiovascular disease risk and treatment response to antioxidant vitamins in some non-pregnant populations. We previously demonstrated that preeclampsia risk was doubled in white Hp 2-1 women, compared to Hp 1-1 women. Our objectives were to determine whether we could reproduce this finding in a larger cohort, and to determine whether Hp phenotype influences lack of efficacy of antioxidant vitamins in preventing preeclampsia and serious complications of pregnancy-associated hypertension (PAH). This is a secondary analysis of a randomized controlled trial in which 10,154 low-risk women received daily vitamin C and E, or placebo, from 9-16 weeks gestation until delivery. Hp phenotype was determined in the study prediction cohort (n = 2,393) and a case-control cohort (703 cases, 1,406 controls). The primary outcome was severe PAH, or mild or severe PAH with elevated liver enzymes, elevated serum creatinine, thrombocytopenia, eclampsia, fetal growth restriction, medically indicated preterm birth or perinatal death. Preeclampsia was a secondary outcome. Odds ratios were estimated by logistic regression. Sampling weights were used to reduce bias from an overrepresentation of women with preeclampsia or the primary outcome. There was no relationship between Hp phenotype and the primary outcome or preeclampsia in Hispanic, white/other or black women. Vitamin supplementation did not reduce the risk of the primary outcome or preeclampsia in women of any phenotype. Supplementation increased preeclampsia risk (odds ratio 3.30; 95% confidence interval 1.61-6.82, p<0.01) in Hispanic Hp 2-2 women. Hp phenotype does not influence preeclampsia risk, or identify a subset of women who may benefit from vitamin C and E supplementation to prevent preeclampsia

Effect of Magnesium Sulfate Administration for Neuroprotection on Latency in Women with Preterm Premature Rupture of Membranes

To evaluate whether magnesium sulfate administration for neuroprotection prolongs latency in women with preterm premature rupture of membranes between 24 and 31 6/7 weeks' gestation

Maternal and Neonatal Outcomes of Repeat Cesarean Delivery in Women with a Prior Classical versus Low Transverse Uterine Incision

We compared maternal and neonatal outcomes following repeat cesarean delivery (CD) of women with a prior classical CD with those with a prior low transverse CD. The Maternal Fetal Medicine Units (MFMU) Network Cesarean Delivery Registry was used to identify women with one previous CD who underwent an elective repeat CD prior to the onset of labor ≥36 weeks. Outcomes were compared between women with a previous classical CD to those with a prior low transverse CD. Of the 7,936 women who met study criteria, 122 had a prior classical CD. Women with a prior classical CD had a higher rate of classical uterine incision at repeat CD (12.73% versus 0.59%; p < 0.001), had longer total operative time and hospital stay, and had higher intensive care unit admission. Uterine dehiscence was more frequent in women with a prior classical CD (2.46% versus 0.27%, OR 9.35, 95% CI 1.76-31.93). After adjusting for confounding factors, there were no statistical differences in major maternal or neonatal morbidities between groups. Uterine dehiscence was present at repeat CD in 2.46% of women with a prior classical CD. However, major maternal morbidities were similar to those with a prior low transverse CD

Relationship of Early Pregnancy Waist-to-Hip Ratio versus Body Mass Index with Gestational Diabetes Mellitus and Insulin Resistance

To determine the risk of gestational diabetes (GDM) and insulin resistance (IR) in obesity defined by body mass index (BMI), waist-to-hip ratio (WHR) or both combined

Repeated course antenatal steroids, inflammation gene polymorphisms, and neurodevelopmental outcomes at age 2

Evaluate the interaction between repeated course antenatal corticosteroids and inflammation gene polymorphisms with neurodevelopmental outcomes at age 2

Umbilical Cord Serum Interleukin-6, C-Reactive Protein, and Myeloperoxidase Concentrations at Birth and Association with Neonatal Morbidities and Long-Term Neurodevelopmental Outcomes

To determine if umbilical cord serum concentrations of interleukin-6 (IL-6), C-reactive protein (CRP), and myeloperoxidase (MPO), in pregnancies at risk for preterm birth (PTB), are associated with neonatal morbidities and/or altered neurodevelopmental outcomes in the children

Laboratory Abnormalities in Pregnancy-Associated Hypertension: Frequency and Association With Pregnancy Outcomes

To estimate the frequency of abnormal laboratory test results in pregnancy-associated hypertension and relationship with pregnancy outcomes