The association between body mass index and postpartum hemorrhage after cesarean delivery.

We aimed to evaluate the association between obesity and postpartum hemorrhage (PPH) after cesarean delivery (CD). This was a retrospective cohort study using a multicenter database of 20 hospitals in the United States. We analyzed 27,708 patients undergoing CD from 2015 to 2019. The exposure of interest was BMI, and the primary outcome was PPH (estimated blood loss [EBL] ≥ 1000 mL). Simple logistic regression was used to evaluate the relationship between obesity and intrapartum complications. Multivariable logistic regression was used to adjust for any confounding demographic variables. Hosmer and Lemeshow's purposeful selection algorithm was adapted to develop a multivariable logistic regression model of PPH. Analyses were conducted using STATA 16.1 (College Station, Texas) with p ≤ 0.05 considered significant. BMI exerted a significant effect on the frequency of PPH (p = 0.004). Compared to patients with BMI 18.5-24.9 kg/m2, patients with BMI between 25 and 59.9 kg/m2 had an increased odds of PPH. The odds of PPH in patients with BMI > 60 kg/m2 was not increased compared to patients with BMI 18.5-24.9 kg/m2. Obesity was associated with a decreased odds of blood transfusion (aOR 0.73, 95% CI 0.55-0.97). In conclusion, higher BMI was associated with PPH yet a lower odds of transfusion after CD.

An educational video's impact on the induction of labor experience: a randomized controlled trial.

BACKGROUND: Induction of labor is a common obstetrical intervention; much research focuses on medical indications, clinical outcomes, and induction agents. Little research has been conducted evaluating the patients' understanding of and satisfaction with induction of labor. Video-based educational tools have been validated as a practical and efficient counseling method by previous studies. OBJECTIVE: This study aimed to evaluate whether an educational video enhances the patients' knowledge about induction of labor and improves satisfaction with the induction of labor process. STUDY DESIGN: This was a single-center study in which women undergoing a scheduled induction of labor were randomized to either the control or intervention group. The control group was given a knowledge questionnaire about induction of labor before meeting their provider (midwife or obstetrician) on the day of scheduled induction of labor. The intervention group was shown a 3-minute educational video about induction of labor before administration of the knowledge questionnaire. Both groups, 24 to 48 hours after delivery, were asked to fill out a second questionnaire about satisfaction with the induction of labor process. Moreover, the video intervention group was asked to evaluate the video in the second questionnaire. Both knowledge and satisfaction questionnaires were compared between the control and intervention groups. RESULTS: From October 2019 to February 2020, 145 women scheduled for induction of labor were eligible and approached for the study. Of the 145 participants, 129 consented and 119 completed the entire study. Moreover, 64 participants were randomized into the control group and 55 into the intervention group. Compared with patients in the control group, the patients who watched the educational video in the intervention group had significantly improved baseline knowledge about induction of labor (P<.001). Knowledge scores remained significantly higher in the intervention group when considering participants who had a previous induction of labor (parity, P<.001; nulliparity, P<.001; multiparity, P<.001). In addition, satisfaction with the induction of labor process among participants in the intervention group was significantly higher than those in the control group (P<.001). Moreover, this held true in those who had a cesarean delivery or had a history of a previous induction of labor (P<.003 and P<.001, respectively). CONCLUSION: A brief educational video about induction of labor improved the patients' knowledge about the induction of labor process and their overall satisfaction with their delivery experience. Video-based education can play an innovative and important role in patient knowledge and satisfaction with the induction of labor process.

Parents of Children with Sickle Cell Disease Are Interested in Preimplantation Genetic Testing.

OBJECTIVE: To evaluate awareness of and attitudes toward preimplantation genetic testing (PGT) for sickle cell disease (SCD) among parents of children with SCD. STUDY DESIGN: Parents of children with SCD were given an educational handbook on PGT before a routine SCD clinic visit. After their clinic visit, parents were asked to complete an anonymous survey. RESULTS: Of 83 patents approached, 67 (81%) completed the survey. Only 16 of the 67 parents (24%) were previously aware of PGT for SCD. After our clinic-based education, 65 of the 67 parents (97%) indicated that it was important or very important for parents of children with SCD to know about PGT. Among parents interested in having more children, 29 of 32 (91%) would personally consider using PGT if covered by insurance. CONCLUSIONS: Parents of children with SCD are generally not aware of PGT. When educated in clinic, parents viewed information on PGT as valuable. Pediatricians and other health care professionals should inform parents of children with SCD about this reproductive option.