Women in higher obesity classes are progressively less likely to initiate breastfeeding. Women with the highest prepregnancy BMIs should be particularly counseled on the benefits of breastfeeding.

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Preterm premature rupture of membranes (PPROM), defined as rupture of the amniotic membranes before 37 weeks' gestation, occurs in 2%-3% of pregnancies.• In patients with PPROM, a sterile speculum examination may reveal pooling of fluid that tests positive for high pH with nitrazine and for ferning under microscopy, as well as leakage of fluid from the cervical os; alternatively, AmniSure testing of the pooled fluid may be positive.