Maternal-fetal Medicine
WHO Report | Global progress in tackling maternal and newborn deaths stalls since 2015
25 May, 2023 | 11:36h | UTCNews Release: Global progress in tackling maternal and newborn deaths stalls since 2015: UN – World Health Organization
WHO Report | 152 million babies born preterm in the last decade
23 May, 2023 | 13:15h | UTCNews Release: 152 million babies born preterm in the last decade – World Health Organization
Report: Born too soon: decade of action on preterm birth – World Health Organization
Consensus Statement | Management of arrhythmias during pregnancy
23 May, 2023 | 13:00h | UTC2023 HRS Expert Consensus Statement on the Management of Arrhythmias During Pregnancy – Heart Rhythm
News Release: Management of Arrhythmias During Pregnancy Consensus Statement Emphasizes Shared Decision-Making – European Heart Rhythm
Special Supplement | Labor and delivery at term – partograms, labor disorders, analgesia/anesthesia, and fever
22 May, 2023 | 13:51h | UTC
Cluster RCT | Early detection and treatment bundle reduces postpartum hemorrhage complications
16 May, 2023 | 15:02h | UTCSummary: An international, cluster-randomized trial assessed the effectiveness of a multicomponent clinical intervention for postpartum hemorrhage in patients having vaginal delivery. The study involved 80 secondary-level hospitals across Kenya, Nigeria, South Africa, and Tanzania, with 210,132 patients. The intervention group utilized a calibrated blood-collection drape for early detection of postpartum hemorrhage and a first-response treatment bundle, while the control group received usual care.
The primary outcome measured was a composite of severe postpartum hemorrhage (blood loss ≥1000 ml), laparotomy for bleeding, or maternal death from bleeding. The results showed a significant reduction in primary-outcome events in the intervention group (1.6%) compared to the usual-care group (4.3%) with a risk ratio of 0.40 (95% CI, 0.32 to 0.50; P<0.001). Postpartum hemorrhage detection rates were 93.1% and 51.1% in the intervention and usual-care groups, respectively, and treatment bundle adherence was 91.2% and 19.4%, respectively.
These findings demonstrate that early detection of postpartum hemorrhage and the use of a bundled treatment approach can significantly reduce the risk of severe postpartum hemorrhage, laparotomy for bleeding, or death from bleeding among patients having vaginal delivery. The results have important implications for improving clinical practice and reducing postpartum hemorrhage complications globally.
Article: Randomized Trial of Early Detection and Treatment of Postpartum Hemorrhage – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary: Lifesaving solution dramatically reduces severe bleeding after childbirth – World Health Organization
Commentary on Twitter
In a large, cluster-randomized trial involving patients with PPH after vaginal delivery, a multicomponent intervention lowered the risk of severe PPH, laparotomy for bleeding, or maternal death from bleeding. Full results of the E-MOTIVE trial: https://t.co/NjcE4Q1rxM#IMNHC2023
— NEJM (@NEJM) May 9, 2023
RCT | Optimizing the timing of whooping cough immunization in mums through investigating pertussis vaccination in pregnancy
16 May, 2023 | 14:49h | UTC
Care plan for individuals at risk for preeclampsia: shared approach to education, strategies for prevention, surveillance and follow up
10 May, 2023 | 16:04h | UTCCommentary: Care Plan Developed for Individuals at Risk for Preeclampsia – HealthDay
Single-arm study | Halting endocrine therapy for pregnancy not linked to increased breast cancer events vs. a control cohort
10 May, 2023 | 16:01h | UTCInterrupting Endocrine Therapy to Attempt Pregnancy after Breast Cancer – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
In women with previous breast cancer who temporarily discontinued adjuvant endocrine therapy to attempt pregnancy, the frequency of breast cancer events was below the prespecified safety threshold and similar to that in controls (POSITIVE trial). https://t.co/zM3f4SbgjE
— NEJM (@NEJM) May 3, 2023
RCT | Early treatment of gestational diabetes slightly lowers risk of adverse neonatal outcomes
9 May, 2023 | 14:55h | UTCTreatment of Gestational Diabetes Mellitus Diagnosed Early in Pregnancy – New England Journal of Medicine (link to abstract – $ for full-text)
News Release: Early treatment of gestational diabetes for those at higher risk beneficial, study finds – Western Sidney University
RCT | Single-dose intravenous iron not superior to oral iron for pregnancy anemia
8 May, 2023 | 12:52h | UTCNews Release: Landmark Malawi trial boosts iron levels in pregnant women – Walter and Eliza Hall Institute of Medical Research
Commentary from the author on Twitter
Very excited to announce the publication of our clinical trial – REVAMP – in @TheLancet: https://t.co/Zpd9500u6b. We evaluated intravenous iron vs oral iron's efficacy and safety in recovering anaemia in Malawian pregnant women. Check out this thread to learn what we found👇 pic.twitter.com/que9hefUhM
— Ricardo Ataide (@ricardoataide) April 24, 2023
Cohort Study | There is no association between labor epidural analgesia and risk of offspring autism and ADHD
4 May, 2023 | 13:30h | UTC
Commentary with video on Twitter
AJOG Presents: Labor epidural analgesia and subsequent risk of offspring autism spectrum disorder and attention-deficit/hyperactivity disorder: a cross-national cohort study of 4.5 million individuals and their siblings https://t.co/XFbedq7SAz pic.twitter.com/J4Mu5xSwT6
— AJOG (@AJOG_thegray) February 4, 2023
RCT | Levonorgestrel IUS vs. hysteroscopic niche resection for postmenstrual spotting in cesarean scar
3 May, 2023 | 15:15h | UTC
Criteria for placental examination for obstetrical and neonatal providers
28 Apr, 2023 | 13:06h | UTC
Position Statement | Transthoracic echocardiographic assessment of the heart in pregnancy
28 Apr, 2023 | 12:57h | UTC
Brief Review | Thyroid disease in pregnancy
25 Apr, 2023 | 14:15h | UTCThyroid disease in pregnancy – Clinical Medicine Journal
Guideline Update | Diagnosis and management of hypertension in pregnancy
24 Apr, 2023 | 13:43h | UTC
Cohort Study | Prenatal exposure to antiseizure medication and incidence of childhood-onset psychiatric disorders
24 Apr, 2023 | 13:10h | UTCPrenatal Exposure to Antiseizure Medication and Incidence of Childhood- and Adolescence-Onset Psychiatric Disorders – JAMA Neurology (link to abstract – $ for full-text)
Author Interview: Prenatal Exposure to Antiseizure Medication and Psychiatric Disorders – JAMA
Commentary on Twitter
Study strengthens the evidence for the warning against the use of valproate in pregnancy, supports concerns about the use of topiramate, and provides a preliminary indication for caution with the use of levetiracetam in pregnancy. https://t.co/BZzZP0tSZs
— JAMA Neurology (@JAMANeuro) April 17, 2023
Review | The management of pregnant trauma patients
24 Apr, 2023 | 13:01h | UTCThe Management of Pregnant Trauma Patients: A Narrative Review – Anesthesia & Analgesia (free for a limited period)
See also: Infographic (free for a limited period)
RCT | Pregnant individuals benefit from brief interpersonal psychotherapy for depression
21 Apr, 2023 | 13:05h | UTCCommentary: Interpersonal Psychotherapy Reduces Depression Symptoms of Pregnant Women – HCP Live
Commentary on Twitter
A randomized clinical trial of prenatal interpersonal psychotherapy showed rapid decreases in depression. Depression in the intervention group dropped from 37% before intervention to 6% after (vs. 26% in control group). https://t.co/rJADZZkfER
— JAMA Psychiatry (@JAMAPsych) April 19, 2023
RCT | Prophylactic tranexamic acid in cesarean delivery did not significantly reduce maternal death or transfusion risk
19 Apr, 2023 | 13:22h | UTCTranexamic Acid to Prevent Obstetrical Hemorrhage after Cesarean Delivery – New England Journal of Medicine (link to abstract – $ for full-text)
News Release: Tranexamic acid does not appear to prevent maternal hemorrhage after cesarean delivery – National Institutes of Health
Commentary on Twitter
In a placebo-controlled trial involving patients undergoing cesarean delivery, prophylactic use of tranexamic acid did not lead to a significantly lower risk of a composite outcome of maternal death or blood transfusion. https://t.co/iB3axZiVqw pic.twitter.com/RDFUsspIr0
— NEJM (@NEJM) April 12, 2023
Guideline | Intrahepatic cholestasis of pregnancy
18 Apr, 2023 | 13:24h | UTCIntrahepatic cholestasis of pregnancy – BJOG
M-A | McDonald vs. Shirodkar cerclage technique in the prevention of preterm birth
18 Apr, 2023 | 13:22h | UTC
RCT | Operative hysteroscopy vs. vacuum aspiration for incomplete spontaneous abortion
18 Apr, 2023 | 13:04h | UTCOperative Hysteroscopy vs Vacuum Aspiration for Incomplete Spontaneous Abortion: A Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)
Commentary on Twitter
Study does not support the use of hysteroscopy as the first-line surgical treatment for patients with incomplete spontaneous abortions. https://t.co/pNI9XOmzae pic.twitter.com/FgWytS2XeR
— JAMA (@JAMA_current) April 14, 2023
M-A | Efficacy of postpartum pharmacologic thromboprophylaxis
17 Apr, 2023 | 12:55h | UTC
SR | Mechanical methods for induction of labor
17 Apr, 2023 | 12:42h | UTCMechanical methods for induction of labour – Cochrane Library
Summary: Mechanical methods for induction of labour – Cochrane Library