Objective-To compare respiratory compliance (Crs) and functional residual capacity (FRC) in infants randomized to a rescue course of antenatal steroids (AS) versus placebo.Study Design-Randomized, double-blinded trial. Pregnant women ≥ 14 days after initial AS were randomized to rescue AS or placebo. The primary outcomes were measurements of Crs and FRC. This study is registered with clinicaltrials.gov [NCT00669383].Results-44 mothers (56 babies) received rescue AS and 41 mothers (57 babies) received placebo. There was no significant difference in birth weight, or head circumference. Infants in the rescue group had an increased Crs (1.21 versus 1.01 mL/cm H 2 O/kg; adjusted 95% CI 0.01, 0.49; p =0.0433) compared to placebo. 13% in the rescue versus 29% in the placebo group required ≥ 30% oxygen (p <0.05). Patients delivered at ≤ 34 weeks had greater pulmonary benefits.Conclusion-Infants randomized to rescue AS have a significantly increased Crs compared to placebo.

Whether seeing a patient in the ambulatory clinic environment, performing a delivery or managing a critically ill patient, obstetric care is a team activity. Failures in teamwork and communication are among the leading causes of adverse obstetric events, accounting for over 70% of sentinel events according to the Joint Commission. Effective, efficient and safe care requires good teamwork. Although nurses, doctors and healthcare staff who work in critical care environments are extremely well trained and competent medically, they have not traditionally been trained in how to work well as part of a team. Given the complexity and acuity of critical care medicine, which often relies on more than one medical team, teamwork skills are essential. This chapter discusses the history and importance of teamwork in high-reliability fields, reviews key concepts and skills in teamwork, and discusses approaches to training and working in teams.

Simulation and team training significantly improved postpartum hemorrhage response times among clinically experienced community labor and delivery teams.

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The available data do not provide evidence to support a policy of cesarean delivery for infants with abdominal wall defects.