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Congenital Mullerian duct anomalies are conditions involving the female genital tract. Cases of complex Mullerian duct anomalies with involvement of the renal system are rare. Occasionally, these cases can be associated with obstetrical complications. Cervical prolapse infrequently complicates pregnancy, and an association between uterine malformations and cervical prolapse has not been cited in the literature. We describe the case of a primigravid patient at 38 weeks of gestation noted to have cervical prolapse during evaluation for preeclampsia and labor induction. Obstetrical ultrasound at presentation to the labor and delivery suite revealed a high suspicion for a bicornuate uterus. The patient was delivered by cesarean section due to obstruction of the lower uterine segment of the gravid uterus. Further evaluation post-partum revealed a bicornuate bicolis uterus and renal agenesis. Pregnancies in patients with bicornuate bicollis uterus can be complicated by obstruction of the gravid uterus, resulting in cervical prolapse and necessitating cesarean section.

Objective: To compare maternal and neonatal outcomes in women with chronic hypertension by maternal race and ethnicity. Methods: A retrospective cohort study of women with chronic hypertension from the Consortium on Safe Labor (2002-2008). Maternal self-reported race and ethnicity were analyzed as non-Hispanic white, non-Hispanic black, and Hispanic. Maternal outcomes included cesarean birth, postpartum hemorrhage (PPH), blood transfusion, placental abruption, eclampsia, maternal intensive care unit (ICU) admission, and death. Neonatal outcomes included preterm birth (PTB), low birth weight (LBW), small for gestational age (SGA), 5-minute Apgar <7, respiratory distress syndrome, hypoxic-ischemic encephalopathy (HIE), intraventricular hemorrhage (IVH), neonatal intensive care unit (NICU) admission, sepsis, and death. Univariable and multivariable analyses were performed to examine the association between maternal race and ethnicity and perinatal outcomes. Results: A total of 2,729 women were included. In unadjusted analysis, non-Hispanic white women had higher rates of placental abruption, and Hispanic women had higher rates of placental abruption and eclampsia. In multivariable analysis, non-Hispanic black continued to have higher odds of placental abruption (aOR 4.16, 95% CI 1.29-18.70), but the rest of the maternal outcomes did not differ between the groups. When comparing neonatal outcomes, preterm birth, SGA and LBW were more frequent in, 5-minute Apgar <7non-Hispanic black and Hispanic women compared with non-Hispanic white women. In addition, 5-minute Apgar <7 and neonatal sepsis were more frequent in non-Hispanic black neonates and neonatal death was more frequent in Hispanic neonates, compared with non-Hispanic white women. In multivariable regression, neonates of non-Hispanic black women had higher odds of PTB, SGA, LBW, 5-min Apgar<7, and sepsis compared with non-Hispanic white women. Similarly, neonates of Hispanic women had higher odds of SGA, LBW, and death. Conclusion: Significant racial and ethnic disparities were identified mainly in neonatal outcomes of women with chronic hypertension.

asymptomatic). Of those enrolled, 93 tested positive, 47 negative, and 20 never underwent recommended testing. One hundred thirty women (81%) responded to at least one text each day, with 98 (61.3%) managed without escalation. Automated escalation occurred in 32(20%) women (75% Black), with 28 directed to continue self-monitoring at home and 4 directed to an ED. Of those directed to the ED, 2 (50%) women were admitted due to hypoxia. None of the asymptomatic postpartum women worsened after discharge. Women who did not respond (n¼30) or did not escalate did not have any office or ED visits within the health system related to COVID-19. CONCLUSION: Automated text-messaging was effective in remotely monitoring pregnant and postpartum women with confirmed or suspected COVID-19, thereby improving the efficiency and reducing resources needed for follow up. The majority of pregnant women were able to remain outpatient while appropriately identifying patients with worsening disease severity.

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