Herein, we report a decreased incidence of composite wound complications with subcuticular staple closure versus traditional staple closure in patients undergoing cesarean section. Absorbable subcuticular staple closure represents a convenient, safe and cost-effective closure technique.

Introduction Fat embolism is a rare form of nonthrombotic embolization. Limited literature exists regarding the diagnosis of fat embolism during the perinatal period. We present the first case of maternal death that resulted from nontraumatic fat embolization following Cesarean delivery. Case Description A 29-year-old gravida 1 with a complex medical and surgical history underwent a primary Cesarean delivery at term. On postoperative day 2 the patient was found to be unresponsive. Despite resuscitative efforts, the patient succumbed. Autopsy findings were remarkable for diffuse pulmonary fat emboli. Furthermore, there was no histological evidence of either amniotic fluid embolism or thromboembolism. The primary cause of death was attributed to nontraumatic fat embolization. Discussion Multiple risk factors may have contributed to the development of nontraumatic fat embolization in our patient. Obstetricians should maintain a high level of suspicion for nontraumatic fat embolization in cases of maternal respiratory decompression and sudden maternal mortality.

What are the novel findings of this work? Soluble neuropilin-1, a member of the vascular endothelial growth factor family involved in branching angiogenesis, is present in maternal plasma and is significantly downregulated in pregnancies with fetal growth restriction (estimated fetal weight < 10 th percentile), but only in those with abnormal umbilical artery Doppler. What are the clinical implications of this work?Maternal plasma soluble neuropilin-1 could serve as a novel biomarker for fetal growth restriction and for distinguishing constitutionally small fetuses from those with true growth compromise.

May Thurner Syndrome contributes to thromboembolic disease and can cause significant morbidity in pregnant patients secondary to exaggerated anatomic relationships and physiologic changes in the hematologic system favoring thrombogenesis. Because this condition is both underrecognized and underreported, management in pregnant and postpartum patients is based on expert opinion without any formal evidence-based guidance. Herein, we review five pregnancies in four patients with May Thurner Syndrome and general management strategies. Through collaborative and multidisciplinary care, patients with May Thurner Syndrome can be safely and successfully managed during pregnancy and the postpartum period with appropriate anticoagulation.

No abstract