OBJECTIVE To evaluate the accuracy of International Classification of Diseases, Tenth Revision (ICD-10) codes for placenta accreta spectrum (PAS) by analyzing frequency and reasons for miscoding, with particular attention to differences between PAS referral centers and other nonreferral obstetric hospitals. METHODS We conducted a retrospective cohort study of all deliveries with ICD-10 codes for PAS

OBJECTIVE To assess variation in inpatient antepartum management strategies for placenta accreta spectrum (PAS) disorder and their association with hospitalization costs in a national sample. METHODS This retrospective cohort study used the 2016-2021 Nationwide Readmissions Database to identify individuals aged 15-54 years who underwent cesarean hysterectomy for PAS between 23 and 35 weeks of gestation

Placenta accreta spectrum (PAS) disorder, characterized by failure of the abnormally adherent placenta to detach from the uterus after delivery, is a leading cause of severe maternal morbidity. Despite its relatively low incidence, disproportional contributions to perinatal hemorrhage, massive transfusion, and emergency hysterectomy underscore the critical need for development of evidence-based surgical

OBJECTIVE To evaluate maternal outcomes when leaving the placenta in situ for placenta accreta spectrum (PAS) according to planned surgical management. METHODS We conducted a single-center retrospective cohort study of patients with PAS managed by leaving the placenta in situ from January 2015 to October 2024. At our center, patients are given options other than cesarean hysterectomy for the management

OBJECTIVE To evaluate whether using a 4-French balloon aortic occlusion device was associated with lower blood loss and subsequent blood transfusions in placenta accreta spectrum (PAS) cesarean hysterectomy. METHODS This was a retrospective cohort study of patients with ultrasound findings consistent with complex PAS (placenta increta or percreta) who were delivered at a single tertiary care center

The nulliparous, term, singleton, vertex (NTSV) cesarean birth rate is a metric that may be used to evaluate obstetric care and compare performance across similar hospitals and regions. Safe reduction of primary cesarean birth prevents the need for future cesarean births and associated maternal morbidity risk. Quality-improvement methodologies such as optimizing culture of care; practice environment;

Prenatal care is one of the most common preventive services in the United States; it is designed to improve the health and well-being of pregnant and birthing individuals and their children through evidence-based services. Despite the prevalence of prenatal care, formalized models of prenatal care delivery have changed little since they were first published in 1930. The purpose of this Clinical Consensus

Although the Americans with Disabilities Act has been the law for more than 30 years, individuals with disabilities still face substantial barriers to health care and are at higher risk of receiving inadequate care than those without disabilities. It is important that obstetrician-gynecologists are aware of best practices for caring for their patients with disabilities, as well as how to adjust their

OBJECTIVE To establish contemporary rates of maternal morbidity and placenta accreta spectrum (PAS) based on history of cesarean delivery and placental location at a single institution. METHODS This is a retrospective cohort study conducted between January 2011 and May 2024. All patients who delivered by cesarean were included. Maternal demographics and morbidities, including rates of PAS, placenta

Although diffuse, ongoing bleeding due to refractory coagulopathy is not frequently encountered in obstetric surgery, patients with placenta accreta spectrum undergoing cesarean hysterectomy are at uniquely high risk for this occurrence. Therefore, obstetrician-gynecologists (ob-gyns) should be familiar with strategies to manage these rare but critical surgical situations. Abdmoinopelvic packing, a

OBJECTIVE To compare maternal and surgical outcomes between local resection and immediate hysterectomy after cesarean delivery in patients with placenta accreta spectrum. DATA SOURCES Four public databases (PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials) were systematically searched for relevant publications up to July 31, 2024. Because the Cochrane Library included

Placenta accreta spectrum (PAS) is associated with significant maternal morbidity, but inconsistent outcome reporting across studies hampers meaningful comparisons of management approaches. This statement proposes standardized criteria for measuring severe maternal morbidity and mortality (SMM) for PAS, distinguishing true complications from expected interventions in care. Traditional SMM definitions

Placenta accreta spectrum (PAS) is a disorder secondary to abnormal development of placental trophoblasts, resulting in invasion of the maternal uterine tissue beneath the placenta. The incidence of PAS continues to rise as a result of several factors, with the most common being the increasing number of cesarean deliveries. The diagnosis of PAS carries significant increased risk of maternal morbidity

Placenta accreta spectrum (PAS) disorders present a significant clinical challenge, characterized by abnormal placental adherence to the uterine wall secondary to uterine scarring. With the rising global cesarean delivery rates, the incidence of this iatrogenic disorder has increased, underscoring the critical need for an understanding of its pathophysiology to inform management and prevention strategies

The management of multiple pregnancies complicated by monochorionicity continues to evolve as new investigations support a change in clinical practice to optimize outcomes. Monochorionic twins are at risk of unique conditions such as monoamnionicity, conjoined twinning, twin reversed arterial perfusion sequence, twin-twin transfusion syndrome, twin anemia-polycythemia sequence, unequal placental sharing

OBJECTIVE To assess the association between the Social Vulnerability Index (SVI) and racial disparities in pregnancy outcomes across U.S. counties and to quantify these racial disparities. METHODS This was a cross-sectional study using restricted Centers for Disease Control and Prevention data sets, including natality data sets, fetal death data sets, and all-cause mortality data sets from 2016 to

OBJECTIVES To provide clinicians with a standardized educational tool to effectively counsel transgender and gender-diverse (TGD) patients on fertility preservation and to support informed consent before interventions that may affect future fertility. PROJECT SUMMARY After performing a literature search, we wrote a detailed script outlining fertility-preservation options and considerations for TGD

OBJECTIVE To educate health care professionals and nurses on buprenorphine initiations in pregnancy, establish a mutual care agreement to promote therapeutic partnership, and standardize buprenorphine initiation using the Epic electronic health record (EHR) order set. PROJECT SUMMARY This project provides resources that can be adapted and implemented at other institutions to perform inpatient buprenorphine

OBJECTIVE To compare characteristics of patients ordering abortion medications from a telehealth service for potential future use (advance provision) with characteristics of patients ordering medications to terminate a current pregnancy. METHODS This cross-sectional study used electronic medical records from a U.S. clinician-supported asynchronous telehealth service to compare patient characteristics

OBJECTIVE To evaluate the short-term effectiveness of fractional CO 2 laser for the treatment of genitourinary syndrome of menopause. DATA SOURCES Systematic review was performed of PubMed, Scopus, Web of Science, Cinhal, MEDLINE, and ClinicalTrials.gov . METHODS OF STUDY SELECTION The included studies had to meet the following criteria: 1) The sample consisted exclusively of women diagnosed with genitourinary

Separation of patients by insurance status in ambulatory care settings is a long-standing practice in academic medicine. This payer-based segregation of patients between resident and faculty outpatient practices may lead to inequitable quality of care. Informed by replies to a free-response text question for residents and program directors within the 2023 U.S. obstetrics and gynecology in-service examination

National rates of trial of labor after cesarean (TOLAC) have increased, but the risk of uterine rupture remains. Clinical practice- and patient-level changes also have occurred in the past decade, and an evaluation of contemporary uterine rupture rates is needed. Using natality files available in the National Vital Statistics System from 2010 to 2022, we conducted a repeated cross-sectional analysis

We conducted a population-based retrospective cohort study and performed interrupted time series analyses to examine whether the removal of race and ethnicity from the vaginal birth after cesarean (VBAC) calculator was associated with changes in rates of trial of labor after cesarean (TOLAC) and VBAC in the United States. After the calculator revision, rates of TOLAC and VBAC in the overall eligible

This cross-sectional study analyzed associations between preconception and prenatal cannabis use and first-trimester nausea and vomiting in pregnancy (NVP) using data from 356,343 pregnancies in a large health care system (2011-2022). Prevalence of preconception and prenatal cannabis use was 11.3% (2.7% daily, 2.4% weekly, 6.3% monthly or less) and 6.5% (0.7% daily, 0.7% weekly, 1.4% monthly or less

OBJECTIVE To investigate the association between the duration of levonorgestrel-releasing intrauterine system (LNG-IUS) use and breast cancer risk in Korean women. METHODS A retrospective cohort study was conducted using the Korean National Health Insurance Claims database from 2013 to 2022. A total of 2,094,029 women aged 30-49 years with initial diagnoses of endometriosis, uterine leiomyomas, or

BACKGROUND Patients with inflammatory bowel disease, particularly Crohn disease (CD), are at increased risk of fat malabsorption and fat-soluble vitamin deficiencies. Vitamin K is a fat-soluble vitamin that plays a critical role in blood coagulation. Vitamin K deficiency during pregnancy can lead to severe maternal and neonatal hemorrhagic complications. CASE We report the case of a patient with severe

OBJECTIVE To quantify how many patients treated for high-grade cervical dysplasia completed guideline-concordant surveillance. METHODS We retrospectively analyzed patients aged 30-65 treated for high-grade cervical dysplasia (cervical intraepithelial neoplasia 2 or worse) at two PROSPR II METRICS (Population-based Research to Optimize the Screening Process Multi-level Optimization of the Cervical Cancer

OBJECTIVE To explore the associations between hypertensive disorders of pregnancy and the subsequent development of autoimmune diseases. METHODS This retrospective cohort study used TriNetX, a federated network of real-world data. Using the Global Collaborative Network data, we collected electronic medical records from 102 health care organizations with 131 million patient records from 2006 to 2020

OBJECTIVE To assess the long-term changes in cardiovascular biomarkers during the WHI (Women's Health Initiative) hormone therapy (HT) clinical trials of conjugated equine estrogens (CEE) alone and CEE plus medroxyprogesterone acetate (MPA). METHODS HT trial participants from the CEE alone (n=1,188, 0.625 mg/d CEE or placebo) and the CEE+MPA (n=1,508, 0.625 mg/d CEE plus continuous 2.5 mg/d MPA or

OBJECTIVE To characterize and estimate rates of fragmented care, to investigate its association with the receipt of guideline-concordant treatment, and to evaluate treatment components at risk with fragmented care. METHODS This is a single-institution retrospective study of patients with locally advanced cervical cancer (stage IB3-IVA) from January 2003 to September 2023. We stratified patients into

OBJECTIVE To compare the performance of four commonly used algorithms to differentiate benign from malignant adnexal masses when used by a novice operator. METHODS Women with adnexal masses treated at Mayo Clinic, Rochester, Minnesota, in 2019 were identified retrospectively. Patients were included if they underwent surgery within 3 months of diagnosis or had at least 10 months of follow-up. A nonexpert

OBJECTIVE To estimate the effect of Medicaid expansion on uninsurance rates and catastrophic charges from emergency surgical management of ectopic pregnancy and ovarian torsion using difference-in-difference analysis and to evaluate for racial and ethnic disparities. METHODS We conducted a retrospective cohort analysis using 2012-2018 State Inpatient Data and State Ambulatory Surgery and Services Databases

OBJECTIVE To evaluate whether cannabis use during pregnancy was associated with depressive symptoms and whether ongoing use beyond the first trimester and higher amounts of cannabis use were associated with increased depressive symptoms. METHODS This was a secondary analysis of the nuMoM2b (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers to Be) study with participants enrolled from October

Our objective was to develop a prediction model for hepatitis C virus (HCV) infection perinatal transmission to improve triage for neonatal follow-up. This was a secondary analysis of HCV antibody-positive participants who were enrolled in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network multicenter observational study of HCV

BACKGROUND Although the fundus is the most likely location of rupture in the gravid uterus, the isthmus is the weakest point, leaving it vulnerable to avulsion during blunt pelvic trauma. We describe a case of uterine avulsion in a gravid patient that was repaired in an attempt to preserve future fertility. CASE A 19-year-old primigravid woman in her second trimester presented with uterine body avulsion

To assess the distribution of gestational age at delivery for patients with placenta accreta spectrum (PAS) in the United States.

To evaluate the effect of a behavioral science-informed intervention designed to facilitate postpartum-to-primary care transitions on primary care visits and screenings within 1 year postpartum for individuals with chronic conditions or pregnancy conditions with long-term health risks.

To identify underlying causes, contributing factors, and quality-improvement opportunities of pregnancy-related hemorrhage deaths.

Little is known about the fetal-neonatal pharmacokinetics of maternally administered, weight-based vancomycin dosing for group B streptococcus (GBS) intrapartum antibiotic prophylaxis. Our objective was to quantify vancomycin concentrations in umbilical cord blood at birth after weight-based maternal intrapartum vancomycin administration and to assess cord blood vancomycin levels relative to the established

Carpal tunnel syndrome (CTS) represents a constellation of symptoms that can occur as a result of compression of the median nerve as it traverses through a constrained space at the level of the wrist. It is the most common compressive mononeuropathy in the human body. Patients frequently present with similar history and physical examination findings, most commonly consisting of numbness of the hand

To evaluate the association between previous non-cesarean uterine surgery and placenta accreta spectrum (PAS) in subsequent pregnancies.

To evaluate whether comorbidities (defined as both medical conditions and peripartum complications) are associated with inpatient postpartum permanent contraception by tubal surgery completion.

Although peak serum total bile acid (TBA) levels guide management of intrahepatic cholestasis of pregnancy (ICP), whether ICP progresses in severity and when or how to assess bile acid levels serially remains unclear. We conducted a secondary analysis of a single-institution retrospective cohort study to assess bile acid trends across pregnancy among individuals diagnosed with ICP and to evaluate whether

The purpose of this review is to serve as an update on congenital cytomegalovirus (CMV) evaluation and management for obstetrician-gynecologists and to provide a framework for counseling birthing people at risk for or diagnosed with a primary CMV infection or reactivation or reinfection during pregnancy. A DNA virus, CMV is the most common congenital viral infection and the most common cause of nongenetic

Obesity is a chronic condition that causes significant morbidity and mortality in people in the United States and around the world. Traditional means of weight loss include diet, exercise, behavioral modifications, and surgery. New weight loss medications, glucagon-like peptide-1 receptor agonists, are revolutionizing the management of weight loss but have implications for fertility and pregnancy.

Legal and accessible abortion care is a necessary component of comprehensive health care. Access to abortion is threatened by local, state, and federal government restrictions; limitations on insurance coverage of abortion care; restrictions on funding for training; restrictions imposed by hospitals and health care systems; stigma; violence against health care professionals who provide abortion care;

To evaluate pregnancy outcomes after transvaginal radiofrequency ablation of leiomyomas.

To investigate short-term maternal and neonatal outcomes in individuals with twin pregnancies and two prior cesarean deliveries who underwent trial of labor after cesarean (TOLAC).

To assess the association between mode of delivery and 2-year motor function in children with prenatal diagnosis of myelomeningocele.

To evaluate the effect of administering postpartum heparin-based pharmacologic thromboprophylaxis on the incidence of postpartum venous thromboembolism (VTE) and complications.

Medical devices are an essential component of the practice of obstetrics and gynecology. These devices may, at times, suffer from a defect or failure, which could result in a product liability lawsuit when associated with patient harm. Medical device product liability lawsuits are directed toward the device manufacturer when a patient suffers harm because of a device. Device manufacturers may, however