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The article presents four ways to lower the risk of an obstetric malpractice suit. These ways include having a clear backup plan if the need to leave the labor and delivery (L&D) department arises, maintaining a balance between allowing residents to develop independent management plans and making decisions that protect patients from the harm caused by inexperience and lack of training, and avoiding a breakdown in communication with a patient after a major obstetric complication.

The article discusses the prevention of neonatal pertussis through maternal immunization, and explores the measures for developing effective vaccination strategies. Also highlighted is the clinical course of pertussis, its diagnosis, and treatment. Time limitations to the efficacy of childhood vaccination and the recommendations for pertussis vaccination by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) are also included.

The article discusses accidental household carbon monoxide (CO) poisoning as the most frequent cause of poisoning in pregnancy. Topics discussed include the need to remain vigilant for CO poisoning during cold winter months as sources of CO production include running vehicles, poorly maintained heating equipment and clogged chimneys and the higher risk of fetal mortality with exposures that are severed and life threatening.

The article discusses the usefulness of having knowledge of fetal lung maturity (FLM) testing for obstetricians and gynecologists. A historical perspective on neonatal morbidities associated with late pre-term and early pre-term delivery is provided. The clinical benefits of conducting FLM evaluation including decision analysis study of amniocentesis risks and determination of patient safety are discussed.

Cytomegalovirus (CMV) is the most common cause of congenital infection and complicates approximately 1% of all live births. Primary maternal CMV infection carries a 30% to 40% risk of vertical transmission to the fetus. In cases where maternal CMV infection is suspected, it is important to evaluate the risk to the fetus to provide appropriate counseling and guidance to parents. This article reviews the published literature and summarizes current diagnostic and management recommendations to help answer the question, should all women be screened for CMV infection in pregnancy?

The Lutheran b blood antigen is a high prevalence antigen occurring in 99.8% of Caucasians. Consequently, antibody formation against Lutheran b is very rare. While this antibody can cause hemolytic reactions in adults, there is limited clinical information on its effects on the fetus and newborn. As a high prevalence antigen, it may be difficult to obtain Lutheran b-negative blood for possible maternal transfusion. We describe two cases of pregnancy complicated by Lutheran b alloimmunization. These cases highlight the potential fetal and maternal complications associated with this antibody and we review options to maximize perinatal outcome.

Group B Streptococcal (GBS) antibiotic susceptibility studies were performed in 95 pregnant women in Bridgeport, Connecticut. Testing for penicillin, ampicillin, cefazolin, and clindamycin sensitivity was performed. Resistance to clindamycin was seen in 5% of isolates. All isolates were susceptible to penicillin, ampicillin, and cefazolin. Clindamycin sensitivity testing should be performed in patients who are allergic to penicillin. GBS remained uniformly susceptible to penicillin and first generation cephalosporins during this study period.