In September 2003, Robert L. Goldenberg and Cortney Thompson published the article “The Infectious Origins of Stillbirth” in the American Journal of Obstetrics and Gynecology. In the article, the authors conducted a literature review of articles from the US National Library of Medicine database to review the relationship between perinatal infections, which are infections around the time of birth, and the occurrence of stillbirth. Stillbirth is the death of a fetus in the uterus after at least twenty weeks of pregnancy. Infectious disease can cause or increase the risk of stillbirth in several ways, by causing illness in the pregnant person, damaging the placenta, or directly infecting the fetus. Infectious agents can be viruses, bacteria, or protozoa. Rates of infectious disease and stillbirth are both higher in developing than in developed countries, and the authors state that stillbirth due to infectious disease is also higher. “The Infectious Origins of Stillbirth” provides a comprehensive review of the information available on how infections can lead to stillbirth, providing a foundation for further research.

Roberto Caldeyro-Barcia studied fetal health in Uruguay during the second half of the twentieth century. Caldeyro-Barcia developed Montevideo units, which are used to quantify intrauterine pressure, or the force of contractions during labor. Intrauterine pressure is a useful measure of the progression of labor and the health of a fetus. Caldeyro-Barcia’s research on fetal health often contradicted common obstetric practices, prompting him to publically challenge practices such as induction of labor using oxytocin, forced pushing during labor, and birth position in which the woman lays on her back during labor. Caldeyro-Barcia’s methods of monitoring intrauterine pressure and development of Montevideo units furthered research in maternal and fetal health and improved the use of medical interventions during labor and delivery.

In the May 1996 edition of The Annals of Surgery, John A. Morris and his collaborators published “Infant Survival After Cesarean Section for Trauma,” in which they evaluate the use of emergency cesarean sections for the treatment of pregnant trauma patients. During a cesarean section, a physician removes a fetus from a pregnant woman through an incision in her abdomen and uterus. When a pregnant woman experiences trauma, physicians can perform an emergency cesarean section to remove the fetus and administer medical treatments that would not be possible while the woman is pregnant. In their article, Morris and his colleagues examine the fetal outcomes following emergency cesarean sections to determine when the procedure should be used in a trauma setting. The authors support the use of emergency cesarean sections in trauma patients when those patients demonstrate high degrees of maternal and fetal distress. Morris and his team’s article is one of the first to focus on how trauma affects third trimester pregnancies and to develop an algorithm to help physicians treat those patients.

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