The Center for Peripartum Optimization

Inclusion criteria

• Records of all female, obstetric patients of child-bearing age who were evaluated in the Center for Peripartum Optimization during the period between January 2017 and January 2018.
• Controlled group will include parturients with match high risk comorbidities or history of nonobstetric surgery during pregnancy who delivered at Johns Hopkins Hospital (JHH) during July 1, 2016 - Dec 31, 2016
• Patients with any one or more of these high risk comorbidities:
• Complex spine pathologies (Scoliosis, vertebral fusion, disc disease, spinal canal defects, neuropathies, and nerve disease, etc.)
• Neurological pathology (Cerebral ischemia, tumor, increased intracranial pressure, cerebral vascular disease, etc.)
• Cardiac disease (Congenital, valvular, pulmonary hypertension, cardiomyopathy, ischemic disease, arrhythmia, etc.)
• Pulmonary disease (History of pulmonary embolism, interstitial lung disease, severe asthma, cancer, etc.)
• Morbid Obesity (Obstructive Sleep Apnea, equipment considerations)
• Hematologic Disorders (Thrombophilias, coagulopathies, patients on anticoagulation)
• Cancer
• Abnormal placentation (Previa, accreta / increta / percreta)
• Anesthetic concerns (Airway abnormalities, history of adverse anesthetic reactions or experiences (i.e. recall, anaphylaxis))
• Fetal therapy patients requiring specialized management (Ex utero intrapartum treatment (EXIT), Fetoscopic endotracheal occlusion (FETO), Twin-to-twin transfusion syndrome (TTTS), Percutaneous Umbilical Blood Sampling (PUBS), etc.)
• Chronic Pain

Exclusion criteria

• Records of CPO participating parturients outside the specified timeframe.
• Records of obstetric patients of child-bearing age without high-risk comorbid conditions described in inclusion criteria.
• Records of patients seen in CPO clinic that did not deliver at our institution