bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hospital Discharge Codes and Overestimating Severe Maternal Morbidity During Delivery Hospitalization
Authors: Quist-Nelson J. , Meng M.-L. , Mallampati D. , Federspiel J.J. , Kucirka L.M. , Fuller M. , Menard M.K. 
Published: November 2024

(Obstet Gynecol. 2024;143(4):582–584. doi: 10.1097/AOG.0000000000005537)
Administrative data play a crucial role in understanding severe maternal morbidity (SMM) events, yet their interpretation heavily relies on coding quality. Overestimation of SMM during birth hospitalizations might occur due to International Classification of Diseases, Tenth Revision (ICD-10) codes being carried forward from predelivery events. This study aimed to describe SMM distribution across the antepartum, birth, and postpartum periods and to assess the potential false discovery rate of SMM events, hypothesizing that some events are subject to carry-forward coding. Following IRB approval and data-use agreements, a shared, deidentified database was created using the PCORnet Common Data Model at the University of North Carolina and Duke University.
The Accuracy of ChatGPT-Generated Responses in Answering Commonly Asked Patient Questions About Labor Epidurals: A Survey-Based Study
Authors: Mootz A.A. , Carvalho B. , Sultan P. , Nguyen T.P. , Reale S.C. 
Published: November 2024

(Anesth Analg. 2024;138(5):1142–1144. doi: 10.1213/ANE.0000000000006801)
Artificial intelligence (AI) is a relatively new mainstream technology that has recently been applied in many different contexts. ChatGPT (Chat Generative Pre-Trained Transformer), created by OpenAI, has previously demonstrated competence in some aspects of clinical reasoning in medical education, though there is little evidence about its ability to answer questions in specific clinical applications. There is no current literature that addresses the medical accuracy of ChatGPT in answering questions related to pregnancy and childbirth. This study was designed to fill that gap and evaluate the accuracy of ChatGPT responses to commonly asked questions about neuraxial analgesia during labor.
The Accuracy of ChatGPT-Generated Responses in Answering Commonly Asked Patient Questions About Labor Epidurals: Correspondence
Authors: Daungsupawong H , Wiwanitkit  
Published: November 2024

(Anesth Analg. 2024;138(6):e37. doi: 10.1213/ANE.0000000000006978)
This article is a response to a comment on the article “The accuracy of ChatGPT-generated responses in answering commonly asked patient questions about labor epidurals: a survey-based study,” which evaluated the accuracy of artificial intelligence (AI) in responding to patient inquiries about epidural medication during labor. The main object of the study was to determine if accurate counsel can be given to patients using AI, using gathered patient questions and evaluating response accuracy.
A Comparison of the Effect of Phenylephrine and Norepinephrine on Uteroplacental Vascular Resistance During the Treatment of Postspinal Hypotension in Preeclamptic Patients: A Randomized Controlled Study
Authors: Fu F , Yang M , Xu L , Chen X 
Published: November 2024

(Eur J Anaesthesiol. 2024;41(2):150–152. doi: 10.1097/EJA.0000000000001924)
Preeclampsia is often characterized by moderate to severe hypertension, and thus postspinal hypotension is less common; however, because of the physiology involved, the effects and hazards of postspinal hypotension in these patients are more severe. Recent research in this area has presented norepinephrine as an alternative to phenylephrine in patients with normal blood pressure and is as yet poorly understood as a treatment for patients with preeclampsia. This article is a letter to the editor describing the outcome of a randomized controlled trial whose aim was to provide evidence for norepinephrine in the context of preeclampsia.
A Spatial Memory Deficit in Male But Not Female Rats After Neonatal Diazepam Exposure: A New Model for Developmental Sedative Neurotoxicity
Authors: Chinn G.A. , Cummins M.H. , Sall J.W. 
Published: November 2024

(Anesth Analg. 2024 Apr 1;138(4):856–865. doi: 10.1213/ANE.0000000000006583)
Current models show that drugs targeting GABA receptors can be very damaging to neurodevelopment, though results are conflicting in human studies as opposed to animal studies. A robust time period of research in animal models has suggested; however, that some differences in cognition caused by anesthetic drugs can be difficult to detect in a clinically significant way, though their presence is a distinct possibility. Previous studies by these authors have investigated the sex-dependent differences in neurodevelopment and thus in response to neurodevelopmental toxicity and have found that both sex and timing of drug administration have significant impacts on neurodevelopmental deficits in later life. Limitations of previous studies include the specificity of the drugs used and variable mechanisms at work in addition to acting as a GABA agonist. This study aims to address these limitations by assessing a similar model of neurodevelopmental toxicity using a benzodiazepine medication, diazepam, which specifically targets GABA receptors. The primary outcome was the effect of diazepam on postnatal day 7 rats on sex-dependent spatial memory deficit.
Perinatal Morbidity Among Women With a Previous Cesarean Delivery (PRISMA Trial): A Cluster-Randomized Trial
Authors: Chaillet N. , Mâsse B. , Grobman W.A. , Shorten A. , Gauthier R. , Rozenberg P. , Dugas M. , Pasquier J.C. , Audibert H.A. , Suzanne D. , Piedboeuf  , Fraser W.D. , Gagnon R. , Gagné G.P. , Francoeur D. , Giard  , Duperron L. , Bédard M.J. , Johri M. , Dubé E. , Blouin S. , Ducret T. , Giard M. , Bujold E. 
Published: November 2024

(Lancet. 2024; 403:44–54. doi: 10.1016/ S0140-6736(23)01855-X)
Pregnant women with a previous cesarean delivery (CD) face a difficult decision between attempting a trial of labor after a cesarean (TOLAC), hoping for a successful vaginal delivery (VD), or opting for a planned repeat CD. Recent studies suggest women need support in decision-making as both delivery modes have unique risks. TOLAC is associated with a risk of uterine rupture and perinatal complications, while repeat CD is associated with an increased risk of maternal complications.
Oxytocin is Not Associated With Postpartum Hemorrhage in Labor Augmentation in a Retrospective Cohort Study in the United States
Authors: Zhu H. , Lu D. , Branch D.W. , Troendle J. , Tang Y. , Bernitz S. , Zamora J. , Betran A.P. , Zhou Y. , Zhang J. 
Published: November 2024

Am J Obstet Gynecol. 2024;230:247.e1–247.e9. https://doi.org/10.1016/j.ajog.2023.07.054
Postpartum hemorrhage (PPH) is a significant cause of maternal mortality and morbidity, affecting about 3% to 5% of obstetric patients, with uterine atony being responsible for over 70% of cases. Recent decades have seen a rise in PPH incidence and an increase in oxytocin use for labor induction and augmentation. Prolonged oxytocin use may desensitize oxytocin receptors in the myometrium, potentially leading to uterine atony and PPH. Previous studies have shown inconsistent results regarding oxytocin’s impact on PPH, mainly due to methodological issues such as confounding by labor dystocia, the primary reason for oxytocin use, and a risk factor for PPH.
The Minimum Effective Dose (ED90) of Prophylactic Oxytocin Infusion During Cesarean Delivery in Patients With and Without Obesity: An Up-Down Sequential Allocation Dose-Response Study
Authors: Tyagi A. , Nigam C. , Malhotra R.K. , Bodh P. , Deep S. , Singla A. 
Published: November 2024

Int J Obstet Anesth. 2024;57:103962. https://doi.org/10.1016/j.ijoa.2023.103962
A leading cause of maternal morbidity and mortality, with uterine atony being the primary factor, is postpartum hemorrhage (PPH). The administration of oxytocin, used as the first-line prophylactic to prevent uterine atony during cesarean delivery (CD), varies in dose, timing, and duration across clinical practices. Lower oxytocin doses are often used to minimize maternal side effects linked to high-dose boluses or empirically titrated infusions. With rising obesity rates and significant pregnancy weight gain, higher oxytocin doses are required for labor induction and augmentation in obese patients. Research indicates obesity may reduce oxytocin-induced myometrial contractility. Despite this, only one study has evaluated the optimal oxytocin dose in patients with a BMI ≥40 kg/m2 undergoing CD, highlighting a need for more research. The study aims to determine the minimum effective oxytocin infusion dose for adequate uterine tone in obese patients, comparing it with a control group of nonobese patients.
The Association Between Maternal Vitamin D Deficiency and Postpartum Hemorrhage and Uterine Atony
Authors: Stevenazzi A.S. , Pihl S. , Blomberg M. , Axelsson D. 
Published: November 2024

(Acta Obstet Gynecol Scand. 2024;103:286–293. DOI: 10.1111/aogs.14719)
Postpartum hemorrhage (PPH) is the leading cause of maternal mortality and morbidity globally, causing about 140,000 deaths per year. PPH can be attributed to 4 primary causes: tone, trauma, tissue, and thrombin. The most common cause is an atonic uterus (70% of cases), followed by trauma (20%), tissue (10%), and thrombin (1%). Hemostasis after delivery primarily relies on uterine myometrium contraction, which compresses the large vessels in the placental bed. Vitamin D deficiency, prevalent globally and in Sweden (25% to 60%), varies with diet, season, and supplementation. It is measured by serum 25-hydroxylated vitamin D (25 OHD) levels, with insufficiency defined as <50 nmol/L and deficiency as <25 nmol/L.
Transabdominal and Transvaginal Ultrasound Findings Help to Guide the Clinical Management of Placenta Accreta Spectrum Cases
Authors: Aryananda R.A. , Duvekot J.J. , Van Beekhuizen H.J. , Clininta N.I. , Ariani G. , Dachlan E.G. 
Published: November 2024

(Acta Obstet Gynecol Scand. 2024;103(1):93–102. doi: 10.1111/aogs.14715)
In recent years, the incidence of placenta accreta spectrum (PAS) has risen while there is no current treatment defined as the standard. The favored conservative surgery options include 1-step conservative surgery (OSCS) and triple-P surgery. Diagnosis of PAS is often accomplished through ultrasound due to ease of use, availability, and low cost. During ultrasound screening many different signs are used to examine the uteroplacental interface, abnormal lacunae, and hypervascularity. Previous studies have sought to link ultrasound signs with histopathology, but the relationship remains unclear. This study aimed to link ultrasound signs and OSCS success, in order to understand how the signs could be used as predictors.
Reference Ranges for Third-Trimester Maternal Cardiovascular Function Parameters Measured in Normotensive Pregnant Women Using a Noninvasive Cardiac Output Monitor: A Study Based on Data From the Prospective PEACH Cohort Study
Authors: Lihme F. , Basit S. , Persson L.G. , Larsen M.O. , Lauridsen K.H. , Lykke J.A. , Andersen A.S. , Halse K. , Thorsen-Meyer A. , Melbye M. , Wolfahrt J. , Boyd H.A. 
Published: November 2024

(BJOG. 2024;131:463–471. doi: 10.1111/1471-0528.17667)
Changes to the cardiovascular system during pregnancy are expected; however, maladaptation is indicative of pregnancy-related cardiovascular disease and should be screened for. Invasive catheterization and echocardiography have traditionally been the tools used for detection of such conditions; however, more noninvasive alternatives have become available, such as the Ultrasound Cardiac Output Monitor 1A (US-COME-1A). This device uses continuous-wave Doppler ultrasound and has been used in pregnant patients with similar results to third trimester echocardiography. Clinicians would benefit further from reference ranges to make this a more useful tool; thus, this study seeks to provide such reference ranges for cardiac output (CO), stroke volume (SV), and systemic vascular resistance (SVR) in singleton pregnancies.
The Contribution of Hypertensive Disorders of Pregnancy to Late Preterm and Term Admissions to Neonatal Units in the UK 2012 to 2020 and Opportunities to Avoid Admission: A Population-Based Study Using the National Neonatal Research Database
Authors: Conti-Ramsden F. , Fleminger J. , Lanoue J. , Chappell L.C. , Battersby C. ,   the UK Neonatal Collective
Published: November 2024

(BJOG. 2024;131:88–98. doi:10.1111/1471-0528.17574)
It is essential to avoid unnecessary admission of infants to neonatal units (NNU). Respiratory distress, infection, and hypoglycemia are common indications for the NNU admission of a full-term neonate. Infants are more likely to be born preterm and be at risk of hypoglycemia if their mother is diagnosed with a hypertensive disorder during pregnancy (HDP). This study focused on quantifying the extent to which maternal HDP affects NNU admission rates among infants born at ≥34 weeks’ gestation with the overall goal of understanding where clinical practice could be improved to reduce NNU admission rates.
Evaluation of Sleep in Pregnant Inpatients Compared With Outpatients
Authors: Panelli D.M. , Miller H.E. , Simpson S.L. , Hurtado J. , Shu C.-H.M. , Boncompagni A.C. , Chueh J. , Barwick F. , Carvalho B. , Sultan P. , Aghaeepour N. , Druzin M.L. 
Published: November 2024

(Obstet Gynecol. 2024;143(6):803–810. doi: 10.1097/AOG.0000000000005591)
Sleep disturbances are common during pregnancy, with up to 42% experiencing issues such as insomnia. A high-risk group includes those hospitalized for pregnancy complications, although research in this area is limited. Approximately 1% of all pregnancies involve antepartum hospitalization. This study compares sleep quality and duration between hospitalized pregnant inpatients and outpatients of similar gestational ages. Previous literature indicates a high prevalence of short sleep duration among antepartum inpatients and suggests that sleep interventions are feasible. Given the link between sleep disturbances and complications like gestational diabetes, hypertensive disorders, and preterm birth, this study evaluates whether antepartum hospitalization affects sleep differently than outpatient care.
Prophylactic Unfractionated Heparin in Antepartum Hospitalizations: A Randomized Controlled Trial
Authors: Mok T. , Nguyen A.V. , Kwan L. , Steinberg  , Vallera C. , Silverman N.S. , Rao R. 
Published: November 2024

(Obstet Gynecol. 2024;144(1):118–125. doi: 10.1097/AOG.0000000000005599)
Obstetric venous thromboembolism (VTE) is a significant cause of maternal morbidity and mortality, particularly in cases of prolonged antepartum hospitalizations. Comprehensive thromboembolism prevention strategies have helped reduce maternal mortality from thromboembolism. Current recommendations emphasize expanded heparin prophylaxis during antepartum hospitalizations to mitigate VTE risks. However, there is a lack of data on how pregnancy-induced physiological changes affect unfractionated heparin (UFH) disposition, potentially necessitating higher dosing during pregnancy. Studies suggest pregnant patients may require increased heparin doses due to lower peak plasma concentrations and altered coagulation parameters.
Association of Pain Catastrophizing With Labor Pain and Analgesia Consumption in Obstetrical Patients
Authors: Peralta F.M. , Condon L.P. , Torrez D. , Neumann K.E. , Pollet A.L. , McCarthy R.J. 
Published: November 2024

(Intl J Obstet Anesthesia. 2024;57:103954. DOI: 10.1016/j.ijoa.2023.103954)
Pain catastrophizing is an exaggerated negative response to pain, linked to increased pain severity and negative outcomes. In obstetrics, it is associated with greater labor pain, more analgesic use, and poor postpartum recovery. This study aimed to quantify the impact of pain catastrophizing on labor and postpartum pain, hypothesizing that high-catastrophizing (HC) women would report higher pain and analgesic use than low-catastrophizing (LC) women.
The Association Between Epidural Labor Analgesia and the Fetal Outcome and Mode of Delivery of the Second Twin: A Nationwide Register-Based Cohort Study in Finland
Authors: Vaajala M. , Kekki M. , Mattila V.M. , Kuitunen I. 
Published: November 2024

(Int J Obstet Anesth. 2023;56:103924. https://doi.org/10.1016/j.ijoa.2023.103924)
Multiple pregnancies carry heightened risk of maternal and fetal health issues, including mortality, compared with singleton pregnancies. However, the perinatal mortality rate for twins in Finland has declined, with rates dropping to 0.7% for the first twin and 1.2% for the second twin in recent decades. While vaginal birth trials are generally safe for twin pregnancies, there remain challenges, especially during the delivery of the second twin, leading to higher complication rates than in singleton births. Epidural analgesia is often beneficial, facilitating obstetric procedures without additional anesthesia, as recommended by the 2019 UK NICE guidelines for reducing emergency cesarean deliveries for the second twin. Despite its advantages, epidural analgesia also poses risks, such as increased chances of operative vaginal delivery and potentially prolonged labor. This study aimed to explore the correlation between epidural analgesia, second-twin delivery mode, and the health outcomes of the second twin.
Influence of Different Volumes and Frequency of Programmed Intermittent Epidural Bolus in Labor on Maternal and Neonatal Outcomes: A Systematic Review and Network Meta-Analysis
Authors: Howle R. , Ragbourne S. , Zolger D. , Owolabi A. , Onwochei D. , Desai N. 
Published: November 2024

(J Clin Anesth. 2024;93:111364. https://doi.org/10.1016/j.jclinane.2023.111364)
Potentially causing physiological and long-term emotional effects, labor is one of the most painful experiences for women. Epidural analgesia, involving the insertion of a catheter and administration of local anesthetics like levobupivacaine and opioids such as fentanyl, is the gold standard for pain relief. Local anesthetics and opioids can be administered through the epidural catheter either by continuous epidural infusion (CEI) or programmed intermittent epidural bolus (PIEB).
Effect of Preoperative Patient Anxiety on Postspinal Shivering During Elective Cesarean Delivery: A Prospective Observational Study
Authors: Jeevan S. , Ashok  , Jain K. , Jain  
Published: November 2024

(Intl J Obstet Anesthesia. 2024;57:103936. DOI: 10.1016/j.ijoa.2023.103936)
It is reported that 36% to 71% of patients undergoing cesarean delivery (CD) under neuraxial anesthesia have intraoperative shivering. Postspinal shivering is traditionally seen as a thermoregulatory response to sympathectomy, but new evidence suggests anxiety might also influence this shivering by affecting the thermoregulatory center. This prospective study investigated the relationship between preoperative anxiety and postspinal shivering in elective CD patients at a single center, and also evaluated other potential risk factors.
Availability of Total Intravenous Anesthesia for Obstetric Surgery: A Survey of UK Practice
Authors: Scale R. , Johnson-Hughes H. , Metodiev Y. 
Published: November 2024

(Eur J Anaesthesiol. 2024;41(2):146–152. doi: 10.1097/EJA.0000000000001855)
Though general anesthesia (GA) is used in only a small percentage of cesarean deliveries (CD), the majority of these instances use a rapid induction with an inhalation agent for maintenance. A newer technique that is rising in popularity is total intravenous anesthesia (TIVA), as it has less of an environmental impact. This article is a letter to the editor that details a survey-based study about the current practice of TIVA in obstetric surgery as well as its availability and barriers to inclusion in routine practice.
Use of the Obstetric Quality-of-Recovery Score (ObsQoR-11) to Measure the Impact of an Enhanced Recovery Programme for Elective Cesarean Section
Authors: Kielty J. , Borkowska A. , Lawlor E. , EL-Khuffash A.F. , Doherty A. , O’Flaherty D. 
Published: November 2024

(Int J Obstet Anesth. 2024;57:103955. https://doi.org/10.1016/j.ijoa.2023.103955)
Cesarean deliveries (CD) are increasingly common worldwide, yet recovery after CD is often slower than after vaginal birth, impacting individuals, families, and workplaces. Enhanced recovery after cesarean (ERAC) programs aim to improve this recovery process. However, there is variability in how ERAC outcomes are reported, hindering comparisons and recommendations. Many current measures, like length of stay (LOS) and pain scores, need to be improved in capturing overall patient recovery. Patient-reported outcome measures (PROMs), such as the Obstetric Quality-of-Recovery (ObsQoR) score, offer a more comprehensive view from the patient’s perspective. Despite their importance, ERAC studies often overlook PROMs. The CRADLE study recently identified vital outcomes, including ObsQoR, for evaluating ERAC programs. We proposed using ObsQoR-11 to assess ERAC’s impact on patient recovery post-CS, expecting improved scores with ERAC implementation.
Federal Priorities to Address Homelessness as a Community Health Problem
Authors: Tsai Jack 
Published: November 2024

Homelessness is a major public health problem across communities in the United States. This commentary reviews required Learning Agendas of all 24 US federal agencies for items related to homelessness and housing instability covering the years 2022-2026. Across 7 federal agencies (Departments of Agriculture; Homeland Security; Labor; Health and Human Services; Housing and Urban Development; Treasury; Veterans Affairs) and 2 cross-government plans (American Rescue Plan Equity; Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex Equity), there is a stated focus on homelessness and housing instability. These federal priorities seek to address homelessness and housing instability in families, Native American communities, unsheltered individuals, veterans, and sexual and gender minority individuals. Several agencies also have a stated focus on evaluating the impact of housing assistance and other supports provided during the COVID-19 pandemic. These findings reflect a national recognition and reframe of homelessness as an interdisciplinary, community health problem with opportunities for inter-agency collaboration and government support for primary and secondary prevention that have not been fully realized.
Elastic Fibers in Orbital Septum
Authors: Kakizaki Hirohiko , Vaidya Aric , Naito Munekazu , Takahashi Yasuhiro 
Published: November 2024

Purpose:
To examine microscopically the nature of the elastic fibers of the orbital septum in elderly specimens in comparison with the young specimen.

Materials and methods:
Histological evaluation of 15 tissues of the orbital septa from upper eyelid (8 right, 7 left) from 11 Japanese cadavers (age range: 36–94 years old, average: 75.5) was performed. The 36-year-old specimen was the only sample with a young age, so it was used as the reference. The age range of the other specimens was, therefore, from 54 to 94, with an average of 79.4 years old. The specimens were fixed in 10% formalin and stained with Elastica van Gieson.

Results:
Elastic fibers in the orbital septa were stained with Elastica van Gieson. The elastic fibers from the elderly specimens illustrated fragmentation, but those from the 36-year-old specimen showed flexibility.

Conclusion:
The elastic fibers in older specimens underwent fragmentation, while those in the young one were flexible.