Prenatal Diagnosis of Vasa Previa: Outpatient Versus Inpatient Management (Abstracted from Am J Perinatol 2019;36:422–427) Vasa previa is defined as fetal vessels that run through the fetal membranes, over or within 2-cm distance from the endocervical os and unprotected by the placenta or umbilical cord. Vasa previa is associated with a high fetal or neonatal mortality rate due to risk of fetal exsanguination resulting from the fetal vessels tearing when rupture of membranes occurs.

Neurodevelopmental Outcome of Children With Spina Bifida Aperta Repaired Prenatally vs Postnatally: Systematic Review and Meta-analysis (Abstracted from Ultrasound Obstet Gynecol 2019;53:293–301) Spina bifida aperta is characterized by a congenital defect in the vertebral arches, with protrusion of the meninges and, in the case of myelomeningocele, protrusion of the spinal cord as well. In the majority of cases, spina bifida is not lethal in the neonatal period, although it is associated with higher mortality than in the normal population (44,000 deaths in 150,000 affected newborns per year worldwide).

Maternal Complications Following Open and Fetoscopic Fetal Surgery: A Systematic Review and Meta-analysis (Abstracted from Prenat Diagn 2019;39(4):251–268) Fetal therapy options have expanded, and surgery on the fetus, placenta, or cord is now relatively common in tertiary-level fetal medicine units. Fetal therapy is almost exclusively offered to mothers who are healthy themselves, yet fetal surgery poses risks to the mother not only during the procedure itself but also during the remainder of the index pregnancy, potentially during any future pregnancies and throughout the woman's entire life.

Incidence of Maternal Tachycardia During the Second Stage of Labor: A Prospective Observational Cohort Study (Abstracted from J Matern Fetal Neonatal Med 2019;32(10):1615–1619) Electronic fetal monitoring has become the primary mode of evaluating the fetus intrapartum, with external Doppler monitoring being the most commonly used method with the criterion standard for fetal heart monitoring, the fetal scalp electrode (FSE), used less frequently. However, Doppler monitoring of fetal heart rate (FHR) presents the possibility of confusion between maternal heart rates (MHRs) and FHRs, referred to as signal ambiguity.

Association Between Year of Birth and 1-Year Survival Among Extremely Preterm Infants in Sweden During 2004–2007 and 2014–2016 (Abstracted from JAMA 2019;321(12):1188–1199) The long-term health outcomes for preterm infants have improved over time, but infants born at extreme preterm gestational ages continue to present issues of optimal antenatal and postnatal management, resource allocation and costs, quality of care, and long-term health outcomes. To better understand variations and time trends for management and outcomes of extremely preterm birth, study of international populations is needed.

Medically Assisted Reproduction and Birth Outcomes: A Within-Family Analysis Using Finnish Population Registers (Abstracted from Lancet 2019;393:1225–1232) Medically assisted reproduction—that is, reproduction brought about through treatments such as ovulation induction, artificial insemination, in vitro fertilization (IVF), or intracytoplasmic sperm injection with fresh or frozen embryo transfer—has resulted in the birth of more than 5 million children. Although previous studies have consistently found that children born after medically assisted reproduction have worse perinatal outcomes than do children who were conceived naturally, the mechanisms underlying this association are not fully understood.

Pregnancy-Adapted YEARS Algorithm for Diagnosis of Suspected Pulmonary Embolism (Abstracted from N Engl J Med 2019;380:1139–1149) Acute pulmonary embolism is one of the leading causes of maternal death, with the overall incidence reported to be 1.72 cases per 1000 deliveries, accounting for approximately 1 death in every 100,000 deliveries. Since the D-dimer test has low specificity and sensitivity, it is common for pregnant women with suspected pulmonary embolism to undergo computed tomography (CT) pulmonary angiography or ventilation-perfusion (V/Q) scanning, both of which involve radiation exposure to the mother and fetus.

Neurodevelopmental Outcomes at Five Years After Early-Onset Fetal Growth Restriction: Analyses in a Dutch Subgroup Participating in a European Management Trial (Abstracted from Eur J Obstet Gynecol Reprod Biol 2019;234:63–70) Uteroplacental insufficiency is the most common cause of fetal growth restriction (FGR), with potentially critical consequences for both the mother and fetus. Definitions of uteroplacental insufficiency vary between an antenatal diagnosis reflecting the placental dysfunction and a postnatal diagnosis based on birth weight.

The Effect of Body Mass Index on Retropubic Midurethral Slings (Abstracted from Am J Obstet Gynecol 2019;220:371.e1–371.e9) The prevalence of obesity during the past 2 decades in England has risen by approximately 40% and is continuing to rise as it has in other developed countries. There is a well-recognized association between stress urinary incontinence (SUI) and increasing body mass index (BMI).

Effect of Postoperative Partial Bladder Filling After Minimally Invasive Hysterectomy on Postanesthesia Care Unit Discharge and Cost: A Single-blinded, Randomized Controlled Trial (Abstracted from Am J Obstet Gynecol 2019;220:367.e1–367.e7) Hysterectomy—one of the most common surgical procedures performed each year in the United States—has substantial related health care costs, more than US $5 billion. In 2010, it was estimated that upward of 430,000 patients received a hysterectomy, with 40% performed laparoscopically and close to half discharged the same day of surgery.