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Nearly everything boils down to communication. It is a cliche to say that communication is a key skill required to lead an organization and to be an effective in your [...]

Match Day capped a momentous year of major changes in our chosen field because of the Dobbs v Jackson Women's Health Organization decision. Of note, it has significantly impacted the [...]

As obstetrics and gynecology providers, we have seen remarkable advancements in 2023, in areas from prenatal obstetrics to intrapartum and postpartum care, and office gynecology and gynecologic oncology. As time [...]

The Society for Maternal-Fetal Medicine 2024 annual meeting was held in Washington, DC, and I took the opportunity to spend some time with a favorite mentor of mine, John T. [...]

The latest United States statistics on stillbirth have been released, reporting an essentially unchanged rate since 2020 for fetal deaths, with 5.7 per 1000 live births and 2.9 per 1000 [...]

Disparities in outcomes-including in obstetrics and gynecology--persist across racial and ethnic lines in part because of social determinants of health (SDOH), which has become an area of interest over the [...]

Advances in technology and access to care over the past few decades have led to a remarkable evolution in determining gestational age and identifying optimal time for delivery. Identifying the [...]

Although leadership in our post-pandemic climate is probably no more challenging than at any other time, it certainly feels that way. Emerging from a period duringwhich routines were upturned, rules [...]

With our cover story focusing on artificial intelligence (AI) and the increasing use of ChatGPT, I thought I should ask ChatGPT to write an editorial on AI in obstetrics and [...]

Let's be positive! I had long understood that it takes fewer muscles to smile than frown. However, I recently learned that this may be incorrect, and more muscles are involved [...]

FALLS BRINGS US BACK TO SCHOOL, for many a comforting tradition of order, back-to-school supplies (unbelievably relaxing to many) and new beginnings. For senior medical students and residents, it is [...]

Maternal mortality has long been regarded as a reflection of how important a population considers women and children to be. The rates in the United States have been troubling for [...]

Obstetrics and gynecologists (ob-gyns) are tough. Thrust into the front lines of the pandemic, we were called upon to not only care for patients with COVID-19 but to do so [...]

National awareness months and days span a variety of topics, from celebrated foods (think National Ice Cream Day, National Bagel Day, National Pizza Day) to businesses (free Slurpee at 7-Eleven) [...]

For more than 70 years, vaccination has been a public health strategy for disease mitigation. Even in populations often considered 'vulnerable'--children and pregnant women--vaccination is strongly recommended and commonly embraced. [...]

Last year was a big one for obstetrics and gynecology, with major legal decisions impacting our practice, stacked on reopening from the pandemic. Additionally, several medical advances have been published, [...]

As we approach the third year of the COVID-19 pandemic, masking, vaccinations, and a 'new normal' have become commonplace around the world. I am thrilled to see that the vaccines [...]

It has been one hot summer, especially here in the Dallas-Fort Worth, Texas, area. We saw a record-breaking streak of consecutive days over 100 [degrees]F and without rain. With the [...]

As we move into yet another surge of COVID-19, the likelihood of remembering what was normal, and if we will 'return' to normal, dims. In the summer months there was [...]

This month we focus on pediatric adolescent gynecologic topics, which are critical to our practices (and our families). It's a growing specialty within our field and often is underappreciated. In [...]

This month, I will share with you an issue I have encountered lately. While I am not advocating anything, I am raising awareness. As a resident physician, I remember how [...]

Rarely a day goes by without a post, article, or email about physician burnout. New variants of coronavirus disease 2019 (COVID-19) and slow vaccination rates are prolonging the quarantine, and [...]

A major missed opportunity. Decades of effort including development of guidance and implementation by individuals, groups, professional organizations, even the United States Congress, to address and facilitate inclusion of pregnant [...]

We are nearing completion of 365 days of unprecedented chaos, at least for me. Although experts in infectious disease have been thinking about and planning for an infectious disease outbreak [...]

With the beginning of 2021, we are eager for resolution to the pandemic. Although reductions in transmission are evident with social distancing, the optimal methods to make social distancing attractive [...]

What a year 2020 has been! We hope to look back on it and recognize it as an outlier or anomaly--hoping life will at some point return to normal. Even [...]

The impact of hospitalization from COVID-19, especially severe disease, has greatly impacted our health care system--particularly the nursing staff. Strain from medical and home demands, along with furloughs as a [...]

My antepartum rounds reflect the impact of the pandemic - women struggling with substance abuse and mental illness fill the beds. One patient, wearing her designated green hospital gown that [...]

Women's health research continues to be marginalized. To address and reverse this trend requires committed, accountable leadership, inclusion of diversity of thought and critical social science issues, in addition to [...]

In the throes of COVID-19, with cases continuing to increase daily at my hospital, we are now further stressed with the brutal death of George Floyd, an African American whose [...]

As we are now incorporating the new post-COVID-19 'normal' into our routines, I was reflecting on the parallels of the changes that went into play with the identification and management [...]

I am honored and delighted to be writing the first of what I hope will be many editorials for Contemporary OB/GYN. Honored in part due to the legacy of the [...]

As physicians, our goal is to provide appropriate, expert medical care--the highest quality--to our patients. Increasingly, external policies and legislation encroach on our ability to provide this care. Despite recommendations [...]

Because August is National Breastfeeding Month, we are providing you with a cover story on it. At Contemporary OB/GYNF, our editorial meetings include an analysis of what articles are performing [...]

Iapplaud providers for encouraging COVID-19 vaccination for pregnant and lactating women. Recent data published from the V-safe pregnancy registry, v-safe after vaccination health checker surveillance system, and the vaccine Adverse [...]

Attention and accountability are the 2 'A's' that drive change. It's true in medicine, business, even family. If it is not monitored, it is not regarded as important nor will [...]

It is recognized that women with gestational diabetes mellitus (GDM) who have significantly elevated fasting blood glucose levels are at increased risk for fetal macrosomia and perinatal morbidity if treatment [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajog.2006.06.046 Byline: Robin Roberson (a), Jade E. Woodard (a), Laura Toso (a), Daniel Abebe (a), Sarah H. Poggi (a)(b), Catherine Y. Spong (a) Abstract: In humans, cerebral palsy (CP) may originate from inflammation during the second and third trimesters of gestation when preoligodendrocytes (Pre-OL) are most vulnerable to an inflammatory insult. We studied a postnatal CP model to evaluate injury that would correlate with presence of Pre-OL in human pregnancy. Author Affiliation: (a) Unit on Perinatal and Developmental Neurobiology, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (b) Department of Obstetrics and Gynecology, INOVA Hospital, Alexandria, VA Article History: Received 8 March 2006; Revised 5 May 2006; Accepted 9 June 2006 Article Note: (footnote) Supported by the Intramural Research Program of the National Institutes of Health, National Institute of Child Health and Human Development and NIAAA. Presented at the 26th Annual Meeting of the Society for Maternal Fetal Medicine, January 30-February 4, 2006, Miami, FL. Reprints not available from the authors.

A study is conducted to determine whether unscheduled cesarean deliveries have complication rates that vary by shift of occurrence, and morbidities are evaluated by delivery shift hypothesizing that such complications would be more frequent during the night shift (11 PM-7 AM) due to sleep deprivation of staff. Results indicate that though neonatal intensive care unit admissions increase at night, maternal and neonatal complications of cesarean delivery do not increase with delivery during the night shift.

The rate of successful trial of labor after previous cesarean delivery for dystocia is assessed in a large cohort based on the relative birth weights of the two pregnancies. It is likely that increased fetal size relative to previous birth weight plays a significant role in the outcome of a subsequent trial of labor for patients with previous cesarean delivery for dystocia, reducing chances of vaginal delivery.

The success rates of vaginal birth after cesarean (VBAC) delivery, uterine rupture and major maternal/perinatal outcomes are compared between women, with previous cesarean deliveries undergoing trial of labor (TOL) with preterm and term pregnancies, and also maternal and neonatal morbidities in women with preterm pregnancies undergoing a TOL versus repeat cesarean delivery without labor (RCD). The likelihood of VBAC success after TOL in preterm pregnancies is comparable to term gestations, with a lower risk of uterine rupture, and perinatal outcomes are similar with preterm TOL and RCD.

A postnatal inflammatory rat model for cerebral palsy (CP) is studied to evaluate white matter damage (WMD) in the brain induced by a chronic stimulus that would correlate with the presence of Pre-OL (preoligodendrocytes) in human pregnancy. It is found that targeting Pre-OL maturation does not result in a discernable CP phenotype in the rat model.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajog.2006.01.098 Byline: Laura Toso (a)(b), Robin Roberson (a), Jade Woodard (a), Daniel Abebe (a), Catherine Y. Spong (a) Abstract: In a model for fetal alcohol syndrome (FAS), we have previously found an alteration in NMDA receptors suggesting mediation, at least in part, of alcohol-related learning deficit. NMDA and GABA receptors interact in a multisynaptic circuit for the regulation of the inhibitory tone through the CNS. The GABA receptor subunit GABA.sub.A[alpha].sub.5 is involved in learning and is developmentally regulated, as it is excitatory in the perinatal brain and inhibitory in the adult. We were interested to evaluate alcohol's effect on GABA.sub.A[alpha].sub.5 expression to further understand alcohol-induced learning dysfunction. Author Affiliation: (a) Unit on Perinatal and Developmental Neurobiology, National Institute of Child and Human Development (b) National Institue of Alcohol Abuse and Alcoholism, National Institute of Health, Bethesda, MD Article History: Received 7 December 2005; Revised 20 January 2006; Accepted 24 January 2006 Article Note: (footnote) Supported by the Division of Intramural Research of National Institute of Child Health and Human Development.

The alcohol's effect on [gamma]- aminobutyric-acid type A [[alpha].sub.5] (GAB[A.sub.A][[alpha].sub.5]) is evaluated in order to understand alcohol-induced learning dysfunction. Prenatal alcohol exposure alters developmental GAB[A.sub.A][[alpha].sub.5] expression, suggesting that alcohol-induced learning impairment is likely the result of alterations of both N-Methyl-D-A-Asparate and GABA expression and function.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajog.2005.12.023 Byline: Laura Toso (a)(b), Melanie Endres (a), Joy Vink (a), Daniel T. Abebe (a), Douglas E. Brenneman (a), Catherine Y. Spong (a) Abstract: Previous work has demonstrated that two synthetic peptides can prevent prenatal alcohol-induced damage as assessed by prevention of learning abnormalities in adult offspring as well as improve outcome from traumatic brain damage. The current studies were undertaken to evaluate whether these peptides could enhance performance in a learning and memory paradigm when administered either prenatally or to aged mice. Author Affiliation: (a) Unit on Perinatal and Developmental Neurobiology, National Institute of Child Health and Development (b) National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD Article History: Received 14 November 2005; Accepted 15 December 2005 Article Note: (footnote) Presented at the Twenty-Fourth Annual Meeting of the American Gynecological and Obstetrical Society, September 29 to October 1, 2005, Victoria, British Columbia, Canada. Reprints not available from the authors.

A study was undertaken to determine whether women with recurrent spontaneous preterm births (rSPBs) having different clinical characteristics or systemic markers than those with isolated preterm (iSPBs) or recurrent term births (rTBs), when assessed remote from delivery. Women with rSPBs are leaner, contract more, have shorter cervixes, and have more advanced Bishop scores than women with iSPBs or rTBs.

A study is conducted to evaluate whether two synthetic peptides could enhance performance in a learning and memory paradigm when administered either prenatally or to aged mice. Findings suggest potential therapeutic interventions during critical developmental period and in aged animals.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajog.2006.01.003 Byline: Laura Toso (a)(b), Sarah H. Poggi (a)(c), Robin Roberson (a), Jade Woodard (a), Jane Park (a), Daniel Abebe (a), Catherine Y. Spong (a) Abstract: Vasoactive intestinal peptide (VIP)-related peptides prevented the learning deficit in the offspring in a model for fetal alcohol syndrome. We evaluated whether the mechanism of the peptide protection included NR2B, NR2A, and GABA.sub.A[alpha].sub.5. Author Affiliation: (a) Unit on Perinatal and Developmental Neurobiology, National Institute of Child and Human Development (b) National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD (c) Department of Obstetrics and Gynecology, INOVA Hospital, Alexandria, VA Article History: Received 7 December 2005; Revised 5 January 2006; Accepted 7 January 2006 Article Note: (footnote) Presented at the 26th Annual Meeting of the Society for Maternal Fetal Medicine, Miami, FL, January 30-February 4, 2006. This work was supported by the Division of Intramural Research of National Institute of Child and Human Development.

A study was conducted to evaluate whether the mechanism of the peptide protection included NR2B, NR2A, and GABA(sub A)alpha(sub 5). The result showed that vasoactive intestinal peptide (VIP)-related peptides prevented alcohol-induced changes in NR2B, NR2A, and GABA(sub A)alpha(sub 5), which explains, at least in part, the peptides' prevention of alcohol-induced learning deficits.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajog.2005.02.105 Byline: Laura Toso (a)(b), Sarah H. Poggi (a)(c), Daniel Abebe (a), Robin Roberson (a), Veronica Dunlap (a), Jane Park (a), Catherine Y. Spong (a)(c) Abstract: Alcohol-related neurodevelopmental disorders are contributors to long-term learning disabilities. By using a model for fetal alcohol syndrome, we have shown that prenatal alcohol exposure results in adult learning deficits of unknown mechanisms. In the developing hippocampus, the N-methyl-D-aspartate (NMDA) receptor subunit NR2B triggers long-term potentiation, fundamental to learning and memory; this is supplemented by the less plastic NR2A subunit in the adult. To understand the mechanism of learning deficits in FAS, we evaluated NR2B and NR2A expression in embryonic and adult mice. Author Affiliation: (a) Unit on Perinatal and Developmental Neurobiology, NICHD (b) National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD (c) Department of Obstetrics and Gynecology, Georgetown University Hospital, Washington, DC Article History: Received 16 November 2004; Accepted 18 February 2005 Article Note: (footnote) Supported by the DIR of National Institutes of Child Health and Human Development.