The Spontaneous Uterine Rupture in Labor: When to Expect the Unexpected.

Uterine rupture is a potentially life-threatening complication that is typically seen in pregnant females who have undergone prior uterine surgeries such as cesarean sections. This usually occurs when the uterine myometrium is weakened and thus is more prone to stress during labor. In an unscarred uterus, the incidence of uterine rupture is lower. Risk factors in the unscarred uterus include trauma, obstructed labor, high parity, placental abnormalities, operative deliveries, and imprudent use of uterotonic medications. This case report describes a situation in which uterine rupture occurred in the absence of the common risk factors. With prompt recognition of clinical signs, quick assembly of a team, and emergent interventions, this patient and her infant survived. The goal of this report is to educate clinicians on the occurrence of uterine rupture in an unscarred uterus and how to recognize and manage this complication.

Effects of the COVID-19 Pandemic on Breastfeeding Rates in a Single Tertiary Health Center.

INTRODUCTION: The coronavirus pandemic has posed many challenges for healthcare facilities. One patient population particularly affected was pregnant women who delivered during the 2020 year. Many antenatal and postpartum services normally available were altered during the pandemic, including the number of available lactation consultants. This change in the availability of lactation consultants led to a decrease in face-to-face breastfeeding education and support for postpartum women. This study aimed to identify if the coronavirus pandemic had a negative effect on breastfeeding prevalence in a single tertiary healthcare center. METHOD: This study was a retrospective chart review with data collected from March 1, 2019-March 1, 2021. The study population was defined as pregnant women age 18 and older who delivered at a single hospital. The prevalence of women who stated they intended to exclusively breastfeed during the pandemic (March 1, 2020-March 1, 2021) was compared to the pre-pandemic year (March 1, 2019-Feb. 29, 2020) as a control. This breastfeeding prevalence was also compared to monthly county-specific coronavirus cases from the South Dakota Department of Health. RESULTS: The prevalence of women who stated they intended to exclusively breastfeed at the time of delivery during the study population was statistically less when compared to the previous pre-pandemic year. CONCLUSIONS: The coronavirus pandemic has posed many challenges for healthcare facilities. One patient populationThe exclusive breastfeeding prevalence was negatively affected during the coronavirus pandemic in this single tertiary health center. Knowledge of this demonstrates patient fears regarding breastfeeding during a pandemic and the importance of lactation education and consultation.

Nonalcoholic Fatty Liver Disease in Women with Polycystic Ovarian Syndrome: A Narrative Review.

Polycystic ovarian syndrome (PCOS) has been estimated to affect 10-15 percent of women in the U.S. Emerging research has found higher rates of nonalcoholic fatty liver disease (NAFLD) among PCOS individuals. While the mechanism continues to be poorly understood the aim of this review is to convey the most recent knowledge regarding the pathogenesis, diagnosis, and treatments for NAFLD in PCOS patients. Elements of insulin resistance, hyperandrogenism, obesity, and chronic inflammation are culprits in the pathogenesis of NAFLD in these patients therefore early liver screening and diagnosis is essential. Although liver biopsy remains the gold standard, advances in imaging modalities show accurate diagnosis and some can even assess the risk of progression to cirrhotic states. Apart from lifestyle modifications resulting in weight loss, other treatments with bariatric surgery, thiazolidinediones, angiotensin-converting enzyme inhibitors (ACE-I)/angiotensin-receptor blockers (ARBs), and vitamin E show promising results.