Serial Cervical Length Evaluation in Low-Risk Women with Shortened Cervical Lengths in the Midtrimester: How Many Will Dilate Prior to 24 Weeks?

For women diagnosed with a short cervix, there is controversy regarding the proper management and follow-up. In this study, we demonstrate that a significant proportion of women with a short cervix in the second trimester will ultimately have a dilated cervix, which is a more concerning situation and often requires different management. These results indicate that one should continue surveillance after the diagnosis of a short cervix.

Induction of Labor versus Cesarean Delivery in Twin Pregnancies

Abstract

For women with twin pregnancies, we have previously shown that outcomes are similar for attempted vaginal delivery as compared to cesarean delivery.  In this study, we demonstrate that this remains true even for women with twin pregnancies who require induction of labor.

Listen to More On Healthful Woman

“Delivery of Twins – Double the Fun!” – with Dr. Stephanie Melka

Subchorionic Hematomas and Adverse Pregnancy Outcomes among Twin Pregnancies

Abstract

Subchorionic hematomas, or subchorionic hemorrhages, are common ultrasound findings in early pregnancy.   However, their significance is uncertain.  Some believe they increase the risk of many pregnancy complications, including pregnancy loss / miscarriage.  In prior studies we demonstrated that subchorionic hematoma does not appear to increase the risk adverse outcomes in singleton pregnancies.

In this study, we present similar results regarding twin pregnancies – subchorionic hematoma does not appear to increase the risk of adverse outcomes in twin pregnancies.

Prior Studies

Association Between First-Trimester Subchorionic Hematomas and Adverse Pregnancy Outcomes After 20 Weeks of Gestation in Singleton Pregnancies

Association Between First-Trimester Subchorionic Hematomas and Pregnancy Loss in Singleton Pregnancies

 

Association Between First-Trimester Subchorionic Hematomas and Adverse Pregnancy Outcomes After 20 Weeks of Gestation in Singleton Pregnancies

Subchorionic hematomas, or subchorionic hemorrhages, are common ultrasound findings in early pregnancy. However, their significance is uncertain. Some believe they increase the risk of many pregnancy complications, including pregnancy loss / miscarriage. In a prior study we demonstrated that subchorionic hematoma does not appear to increase the risk of miscarriage in singleton pregnancies.

In this study, we present similar results regarding other adverse pregnancy outcomes – subchorionic hematoma does not appear to increase the risk of adverse outcomes later in pregnancy.

COVID-19 in Pregnant Women: Case Series from One Large New York City Obstetrical Practice

Abstract

COVID-19 changed the world in 2020.  One of the questions we get a lot is how it affects pregnant women.  However, most studies only include hospitalized patients, making it seem like outcomes are worse than they might be.  In this study, we report our experience with 92 pregnant women (approximately 12% of our pregnant patients) who had known or suspected COVID-19 infection. Fortunately, outcomes were very reassuring.

Learn More on the Healthful Woman Podcast

“Pregnancy in the Land of Corona!” -with Emily Oster

“We’re Still Open 24/7: Labor and Delivery During Corona” – with Dr. Angela Bianco

“Lockdown: Everyone’s at Home!” – with Dr. Michal Agus Fox

“Newborn Babies and Corona” – with Dr. Annemarie Stroustrup

“The Search for the Cure to Corona” – with Dr. Eldad Hod

“Corona: An Inside Report from the Front Lines” – with Dr. Zevy Hamburger

“The Ethics of Fertility Treatments During Corona” – with Dr. Alan Copperman

“PPE, Yeah You Know Me” – with Dr. Sarp Aksel

“Ending the Quarantine: If, When, and How?” – with Emily Oster

Pregnancy Outcomes in Patients With Prior Uterine Rupture or Dehiscence

Uterine rupture is a serious pregnancy complication associated with significant maternal and neonatal morbidity and mortality. For women with a history of uterine rupture, there is a risk of recurrence, ranging in the literature from 0-33%. Owing to this, some women with a prior uterine rupture are advised not to have more pregnancies. In 2014, we reported outcomes for 14 women (20 pregnancies) with a history of uterine rupture (clinically apparent, complete scar separation in labor or before labor) and 30 women (40 pregnancies) with a history of uterine dehiscence (incomplete uterine scar separation with intact serosa, sometimes referred to as a uterine window). In these 60 pregnancies, there was 0% severe morbidity and 6.7% of pregnancies had uterine dehiscence seen at the time of delivery. Subsequent to the 2014 publication, we have seen an increase in patients with a history of uterine rupture or dehiscence, and the objective of this Research Letter is to update our results with a larger sample size.

Dr. Fox was featured on “The Green Journal” discussing this topic. Listen in!