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Half of all premature births in the United States have preterm birth associated risk factors. • Prematurity education is currently offered to parents upon hospitalization for preterm birth. • Lack of prematurity education before the birth hospitalization leaves parents unprepared. • Smartphone-based prenatal prematurity education benefited parents at-risk for preterm birth. • In the majority of participants, the smartphone-based prenatal prematurity education did not increase parental anxiety.

In seven patients vomiting played an important part in the presentation of thyrotoxicosis. Vomiting does not always indicate severe thyroid disease, and the diagnosis in patients presenting with this symptom may be long delayed.

Purpose Opioid use disorder (OUD) during pregnancy is associated with poor maternal and infant outcomes, including neonatal abstinence syndrome (NAS), and both maternal OUD and NAS are increasing disproportionately among rural residents. This study describes the trajectory and characteristics associated with diagnosis of maternal OUD or NAS among rural residents who gave birth at different types of hospitals based on rural/urban location and teaching status. Methods Hospital discharge data from the all‐payer National Inpatient Sample were used to describe maternal OUD and infant NAS among rural residents from 2007–2014. Hospitals were categorized as rural, urban teaching, and urban nonteaching. We estimated incidence trends by hospital categories, followed by multivariable logistic regression analyses to identify correlates of OUD and NAS among rural residents, stratified by hospital category. Findings Incidence of maternal OUD increased in all hospital categories, with higher rates (8.9/1,000 deliveries) among rural residents who gave birth at urban teaching hospitals compared with those who gave birth at rural hospitals (4.3/1,000 deliveries) or urban nonteaching hospitals (3.6/1,000 deliveries; P < .001). A similar pattern was observed for infant NAS. In multivariable models, the association between maternal OUD and infant NAS diagnoses and hospital category differed by rurality (micropolitan vs. noncore.) Conclusions There has been a sustained increase in both maternal OUD and NAS diagnoses among rural residents. Measured sociodemographic and clinical correlates of maternal OUD and NAS differ by hospital category, indicating variability across hospital locations in patient populations and clinical needs for rural residents with these conditions.

This study investigated the effect of sildenafil on uterine volumetric flow (UVF) and vascular impedance in nonpregnant, nulliparous women. Fifteen women were randomized in a double-blind fashion to receive either placebo, or sildenafil (25 or 100 mg) during the luteal phase of the menstrual cycle. Color Doppler ultrasound of both uterine arteries was performed at baseline and 1 and 3-hours post-dosing to calculate resistance index (RI) and UVF. Those who received sildenafil significantly increased UVF and decreased RI over the three hour monitoring period. When UVF responses to sildenafil were examined as a function of baseline UVF, a significant increase in UVF was observed in only those subjects with higher baseline UVF. Overall, women in the luteal phase demonstrated a significant increase in UVF in response to sildenafil. However, this increase appears to be directly associated with basal UVF.