Many women affected by HMB do not seek medical help, and few of those who do consult physicians report that they have received appropriate treatment. HMB continues to be underdiagnosed and poorly treated.

Objectives To assess the precision magnetic resonance imaging (MRI) in the neonate and determine if there is an early maternal influence on the pattern of neonatal fat deposition in the offspring of mothers with gestational diabetes (GDM) and obesity compared with the offspring of normal weight women. Study design 25 neonates, born to normal weight mothers (n=13) and to obese mothers with GDM (n=12), underwent MRI for measurement of subcutaneous and intra-abdominal fat and magnetic resonance spectroscopy for the measurement of intrahepatocellular (IHCL) fat at 1-3 weeks of age. Results Infants born to obese/GDM mothers had a mean 68% increase in IHCL compared with infants born to normal weight mothers. For all infants, IHCL correlated with maternal pre-pregnancy BMI but not with subcutaneous adiposity. Conclusion Deposition of liver fat in the neonate correlates highly with maternal BMI. This finding may have implications for understanding the developmental origins of childhood NAFLD.

In this review, we will discuss current ultrasound Doppler literature and the recommendations of the experts. We observe that the best algorithm for incorporation of the ductus venosus into intrauterine growth restriction management is yet to be determined. This remains a subject of intense research aimed at optimizing pregnancy outcomes and will be important to follow to provide up-to-date care of our patients.

IBD patients are mostly aware of the main signs and symptoms of anaemia. Oral iron is most commonly prescribed, but may cause dissatisfaction because of tolerability issues. Most patients prescribed intravenous iron are satisfied with treatment.

Objective Prenatal maternal anxiety has detrimental effects on the resulting offspring’s neurocognitive development, including impaired attentional function. Antidepressants are commonly utilized during pregnancy, yet their impact on offspring attention and their interaction with maternal anxiety has not been assessed. Using P50 auditory sensory gating, a putative marker of early attentional processes measurable in young infants, the impact of maternal anxiety and antidepressant use are explored. Method Two hundred forty-two mother-infant dyads were classified relative to maternal history of anxiety and maternal prenatal antidepressant use. Infant P50 auditory sensory gating was recorded during active sleep at a mean± standard deviation of 76 ± 38 days of age. Results In the absence of prenatal antidepressant exposure, infants with mothers with a history of anxiety diagnoses had diminished P50 sensory gating (p<.001). Prenatal antidepressants mitigated the effect of anxiety (uncorrected p=.041). The effect of maternal anxiety was limited to amplitude of response to the second stimulus while antidepressants impacted the amplitude or response to both the first and second stimulus. Conclusion Maternal anxiety disorders are associated less inhibition during infant sensory gating, a performance deficit mitigated by prenatal antidepressant use. This effect may be important in considering the risks and benefits of prenatal antidepressant treatment. Cholinergic mechanisms are hypothesized for both anxiety and antidepressant effects; however the cholinergic receptors involved are likely different for anxiety and antidepressant effects. Additional work focused on understanding how treatment impacts the relationship between maternal prenatal illness and offspring neurocognitive development is indicated.

INTRODUCTION: Perinatal mood and anxiety disorders are the most common pregnancy complications, and are associated with adverse maternal, infant and child outcomes. Recognizing this, the Council on Patient Safety in Women's Healthcare developed an evidence-based safety bundle to establish a standard of care for these disorders that is relevant to every woman in every clinical setting. Its objective was to outline how to implement current recommendations at the practice level. METHODS: To promote safety bundle dissemination, the American College of Obstetricians and Gynecologists invited 20 nationally representative obstetric and behavioral health providers to engage in a journey mapping process. The journey map followed the safety bundle format and addressed implementation steps needed to screen for and respond to perinatal mood and anxiety disorders. Opportunities to ease implementation were also assessed. RESULTS: The journey map focused on the process of addressing these disorders and identified multiple potential barriers. Each step of implementation must consider an ever changing obstetric practice environment, and the absence of related direct reimbursement. It is critical to focus on implementation until consensus is reached regarding outcomes measures to assess screening and treatment. CONCLUSION: As the implications of untreated perinatal mood and anxiety disorders are better understood, it is critical to develop and disseminate implementation processes to help obstetric practices screen for and address this issue. Implementation protocols need to be customized to each unique care setting. Further efforts are required to establish meaningful outcome measures.

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