( Am J Obstet Gynecol 2025 Nov;233(5):396–427. doi: 10.1016/j.ajog.2025.04.060) Maternal morbidity and mortality have far-reaching effects, both on families and on society. Reducing maternal mortality (MM) is one of the sustainable development goals of the United Nations; many maternal deaths occur between delivery and 1 year postpartum. An estimated 15% of severe maternal morbidity (SMM) diagnoses are made after discharge from delivery hospitalization in the United States, and these can lead to long-term complications and a reduction in quality of life. Synthesis of current data on incidence and prevalence of MM in the United States and Canada is lacking, and this study was designed to address this gap by reporting the frequency (prevalence and/or incidence) and timing of maternal morbidity and mortality between hospital discharge after delivery and 1 year postpartum.
( Am J Obstet Gynecol 2025;233:651.e1–12. doi: 10.1016/j.ajog.2025.07.046) Maternal fever is a complication affecting up to 10% of deliveries occurring at late preterm or term gestation. The most common causes of fever include infection and epidural use, with fever being more common in nulliparous women and individuals with prolonged labor. Previous animal models have shown fever to be associated with decreased labor tolerance, fetal hypoxia, and metabolic acidosis, as well as the risk of brain injury. Human studies have shown associations of fever with low Apgar scores, acidosis, respiratory distress, neonatal sepsis, meconium aspiration syndrome, hypoxic-ischemic encephalopathy (HIE), and seizures. It is yet unknown whether the intensity and duration of fever during labor are associated with an increased risk of HIE. This study was designed to assess this association as well as the association between duration of fever to delivery and neonatal outcomes.
( Anesth Analg . 2026 Jan 1;142(1):19–27. doi: 10.1213/ANE.0000000000007580) A randomized, blinded, noninferiority clinical trial evaluated whether intrathecal hydromorphone (ITH) provides comparable pain relief to intrathecal morphine (ITM) following elective cesarean delivery (CD). Spinal anesthesia with ITM is widely regarded as the standard approach for post-CD analgesia due to its prolonged pain control. However, its use is associated with adverse effects such as nausea, vomiting, itching, and, in rare cases, respiratory depression. In addition, supply shortages of preservative-free morphine have prompted interest in alternative opioids, including hydromorphone. Although previous studies have established effective dosing levels for both medications, the noninferiority of ITH compared with ITM had not been clearly demonstrated before this study.
( Int J Obstet Anesth 2025;63:104696. doi: 10.1016/j.ijoa.2025.104696) Neuraxial anesthesia (NA) is generally the preferred technique for emergency cesarean delivery (CD) because it offers well-established benefits for both maternal and neonatal outcomes. Despite this, general anesthesia (GA) is used in certain emergency situations, sometimes appropriately and sometimes when alternative approaches may have been feasible. This qualitative study explored how anesthesia trainees decide to administer GA during emergency CD and examined the human factors that influence this complex decision-making process.
( Anaesthesia 2025;80:1247–1253. doi:10.1111/anae.16665) High-flow nasal oxygen (HFNO) has increasingly been explored as an alternative method for preoxygenation and perioperative oxygen delivery in anesthetic practice. Although its use is well established in nonobstetric populations, its effectiveness and clinical value in obstetric anesthesia remain unclear. This systematic review evaluated existing evidence on the perioperative use of HFNO in obstetric patients, with particular attention to maternal oxygenation, airway safety, and neonatal outcomes.
