OB/GYN Clinical Alert – November 1, 2020
November 1, 2020
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Prenatal Care Visits During COVID-19
In this nested case-control study in the Boston area, there was no association between testing positive for COVID-19 during pregnancy or on admission to labor and delivery and the number of in-person prenatal care visits.
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Maternal Sepsis: Risk Factors that Could Lead to Postpartum Readmission
In this analysis of California deliveries between 2008 and 2011, risk factors for maternal readmission for sepsis were found to include preterm birth, hemorrhage, obesity, and a primary cesarean delivery.
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Outpatient Foley Catheter for Induction of Labor in Nulliparous Women
In this randomized controlled trial among nulliparous patients with low Bishop scores, outpatient placement of a Foley catheter the day prior to scheduled admission, when compared to inpatient placement, showed a decreased mean time from admission to delivery.
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Understanding the Utility of Hemoglobin A1c in Diagnosing Gestational Diabetes in Early Pregnancy
In this retrospective cohort study of 243 pregnant women who had combined hemoglobin A1c (HbA1c) and a two-step oral glucose tolerance testing at less than 21 weeks of gestation, median values of HbA1c were higher in women with gestational diabetes compared to nondiabetics (5.8% compared to 5.3%; P < 0.001). The predictive probability of using HbA1c in diagnosing diabetes in early pregnancy was high compared to two-step testing (area under the curve, 0.8), with an optimal diagnostic threshold of 5.6%. Although a HbA1c level of > 6.5% is diagnostic of early gestational diabetes, a lower diagnostic threshold might be justified during pregnancy.