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(J Clin Anesth. 2021;77:110620)The complication of full-term pregnancy by malignancy occurs in an estimated 0.1% of cases. Adenoid cystic carcinoma (ACC) is itself a rare cancer of the head and neck, amounting to just 0.2% of tracheal tumors. As an aggressive carcinoma, ACC produces critical symptoms including airway obstruction often preceded initially by coughing, stridor, dyspnea, and hemoptysis. This case report advances the literature with documentation of the most extensive ACC during pregnancy with advancing tracheal stenosis reported to date, and critical methods by which a difficult airway was managed during cesarean delivery (CD).

(N Engl J Med. 2021;384:2342–2343)Pregnant women were not included in initial trials for the Moderna and Pfizer-BioNTech messenger RNA (mRNA) vaccines for coronavirus disease 2019 (Covid-19), but were among the first persons eligible to receive the vaccines under an Emergency Use Authorization.

Herpes simplex virus (HSV) infection is prevalent worldwide. Herpes labialis, caused predominantly by HSV-1, and herpes vulvovaginitis, caused predominantly by HSV-2, may result in significant morbidity and mortality for infected neonates exposed during delivery. The diagnosis of HSV infection is made by serological testing, viral culture, or polymerase chain reaction. Women with primary herpes vulvovaginitis exhibit a painful vesicular rash which is self-limited but may be followed by multiple recurrences. Women at greatest risk to transmit HSV to their neonates are those who experience their first episode of HSV during the latter stage of pregnancy. If infected, their neonates may have localized skin, eye and mucosal lesions, invasive central nervous system infection, or disseminated disease. Because of the potentially devastating outcome for a baby infected with HSV, pregnant women with active HSV lesions at delivery should be offered a cesarean section. Still, many neonates who are infected with HSV are born to women with asymptomatic HSV shedding. Therefore, prevention of HSV during pregnancy is exceedingly important.

(Obstet Gynecol. 2017;130(4):710–717)Maternal sepsis remains an important contributor to severe maternal morbidity. However, consensus guidelines conflict with evidence-based recommendations encouraging early diagnosis and treatment of febrile peripartum women, and there is no gold standard for the diagnosis of sepsis in pregnancy. In the present study, authors identified exposures associated with bacteremia in febrile women in the peripartum period (primary outcome) and examined associations between adverse outcomes and bacteremia. The degree of initial fever as a clinical predictor was also evaluated.