Objectives: To determine the nosocomial infection rate in women undergoing elective cesarean section Design: Non-randomized prospective cohort trial Setting: Two large-volume obstetrical units at academic institutions Population: Women undergoing elective cesarean section during the reopening phase of the Covid-19 pandemic in New York State Methods: Eligible patients with negative pre-operative Covid-19 reverse transcriptase-polymerase chain reaction test and IgG antibody test were re-tested 6-9 days after discharge. Main Outcome Measures: The primary objective was the Covid-19 test conversion rate defined as a positive PCR test after discharge with a negative pre-operative test. This was used as a proxy for the nosocomial infection rate. Results: No patients with a negative PCR test pre-operatively had a positive PCR test for the Covid-19 virus postoperatively. Conclusions: With a strict and methodical perioperative and postpartum protocol, we can limit nosocomial Covid-19 infections in women undergoing elective cesarean section. Funding: No external funding was obtained for this study Keywords: Covid-19, Cesarean Section, Nosocomial Infection

Objective: To evaluate whether marijuana use in reproductive age women is associated with recurrent bacterial vaginosis. Design: Retrospective chart review. Setting: Ten underserved clinics in New York City, NY. Population: All women of reproductive age (15-45 years old) who presented with a complaint of vaginal discharge from January 1st- December 31st, 2019 and subsequently diagnosed with bacterial vaginosis. Methods: The cohort was divided based on whether they met criteria for recurrent bacterial vaginosis, defined as three or more separate positive vaginal cultures with Gardnerella vaginalis in a year. Descriptive statistics were used to compare both groups in terms of sociodemographic and medical history. Logistic regression analysis was used to estimate adjusted odds ratios with a 95% confidence interval (CI). Main outcome measures: Compare between marijuana users and non-users the odds of developing recurrent BV. Results Of 4,752 women who presented with a complaint of a vaginal discharge, 1,380 (29.04%) had bacterial vaginosis and of those, 5.8% met the criteria for recurrent bacterial vaginosis. Marijuana use had an adjusted odds ratio of 1.98 for recurrent bacterial vaginosis by multiple logistic regression analysis (95% CI [1.15- 3.34]). Non-Hispanic women had increased odds of developing recurrent bacterial vaginosis compared to Hispanic women (adjusted odds ratio 1.79; 95% CI [1.07- 2.92]). Conversely, increase in age was associated with a slightly decreased likelihood of developing recurrent bacterial vaginosis (adjusted odds ratio 0.95; 95% CI [0.92- 0.98]). Conclusion Reproductive age women who self-report the use of marijuana have twice the odds of developing recurrent BV.

We evaluated the interpretation of atrophic endometrium (AE) histology as a common cause for postmenopausal bleeding (PMB). In our opinion, AE is physiologic and ubiquitous in postmenopausal women, but is not a cause of PMB. Referring to AE as a cause of PMB may result in misdiagnosis of cancer and delay in management. Endometrial sampling are notorious for missing focal lesions and transvaginal sonogram should be considered in cases of PMB and AE histology. If endometrial thickness is found, it is not compatible with AE and further workup is warranted to exclude focal lesions which are common cause for PMB.