Maternal-fetal Medicine
WHO: New report sounds the alarm on global shortage of 900 000 midwives.
6 May, 2021 | 08:45h | UTCNew report sounds the alarm on global shortage of 900 000 midwives – World Health Organization
Report: The State of the World’s Midwifery 2021 – UN sexual and reproductive health agency
Commentary on Twitter (thread – click for more)
9⃣3⃣% of #midwives are women. But too many face persistent gender discrimination that prevents them from thriving professionally.
Gender transformative policies are key to change this! 👉https://t.co/qxkv16SVxp #MidwivesDay #IDM2021 pic.twitter.com/7aBBwvXFQa
— World Health Organization (WHO) (@WHO) May 5, 2021
Cohort study: Risk of developmental difficulties remains high among children born early
5 May, 2021 | 08:24h | UTCNeurodevelopmental outcomes at age 5 among children born preterm: EPIPAGE-2 cohort study – The BMJ
News release: Risk of developmental difficulties remains high among children born early – The BMJ
Commentary on Twitter
Children born preterm remain at high risk of developmental difficulties that can affect their behaviour and ability to learn, finds new research https://t.co/0A1aIQWWqk #BMJResearch
— The BMJ (@bmj_latest) May 2, 2021
RCT: Community-initiated kangaroo mother care reduced the risk of moderate-to-severe maternal postpartum depressive symptoms among mothers of low-birth-weight infants in low-income areas in India
5 May, 2021 | 08:21h | UTC
Commentary on Twitter
Skin to Skin care doesn’t only help babies; it also helps mothers!
Randomized trial of ~2k mothers from India found kangaroo care reduces postpartum depression #neoEBM #mentalhealth @JAMANetworkOpen https://t.co/6YqPQChKLe pic.twitter.com/DYAbU3Tsxu
— Abdul Razak (@DrAbdulRazak_MD) April 23, 2021
The Lancet Series | Miscarriage matters
3 May, 2021 | 05:11h | UTCEditorial: Miscarriage: worldwide reform of care is needed
- Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss
- Sporadic miscarriage: evidence to provide effective care
- Recurrent miscarriage: evidence to accelerate action
RCT: Tranexamic acid for the prevention of blood loss after cesarean delivery – even though TA resulted in a significantly lower incidence of estimated blood loss, the clinical relevance of the findings was small
30 Apr, 2021 | 08:38h | UTC
Commentaries on Twitter
Another typically "positive" trial for TXA.
"the mean between-group difference was approximately 100 ml …. the clinical relevance of this narrow difference is questionable"
– No difference in RBC transfusions.
– 0.4% vs 0.1% VTE at 3 mos.— Ryan Radecki, MD MS (@emlitofnote) April 28, 2021
NEJM-Prevention of Blood Loss after Cesarean Delivery | tranexamic acid ➡️ significantly lower incidence of EBL greater than 1000 ml or RBC transfusion by day 2 than placebo, but did not result in a ⬇️ incidence of hemorrhage-related secondary outcomes https://t.co/ydF5HgHM0N
— Skeptical Scalpel (@Skepticscalpel) April 28, 2021
Cohort study: Association of maternal SARS-CoV-2 infection in pregnancy with neonatal outcomes – “although babies born of test-positive mothers are more likely to be born early, extremely few were infected with COVID-19”
30 Apr, 2021 | 08:17h | UTCAssociation of Maternal SARS-CoV-2 Infection in Pregnancy With Neonatal Outcomes – JAMA
News release: Low risk of infection in babies born to mothers with COVID-19 – Karolinska Institutet
Editorial: Understanding Risk for Newborns Born to SARS-CoV-2–Positive Mothers – JAMA
Commentary on Twitter
Maternal #SARSCoV2 infection in pregnancy was significantly associated with small increases in the absolute risk of respiratory disorders and some other neonatal morbidities https://t.co/ANkXkaxnwp
— JAMA (@JAMA_current) April 29, 2021
Pre-post study: A hospital quality improvement intervention significantly reduced the rates of cesarean delivery for nulliparous, term, singleton, vertex births
29 Apr, 2021 | 08:21h | UTCHospital Quality Improvement Interventions, Statewide Policy Initiatives, and Rates of Cesarean Delivery for Nulliparous, Term, Singleton, Vertex Births in California – JAMA (free for a limited period)
Editorial: Initiatives to Reduce Cesarean Delivery Rates for Low-risk First Births – JAMA
Commentary on Twitter (thread – click for more)
"Rates of cesarean delivery for NTSV births in California decreased [from 26% to 22.8%] in the setting of a coordinated hospital-level collaborative and statewide initiatives designed to support vaginal birth.
"The rest of the US had no change."https://t.co/jwKkQZ4nix @cmqcc
— Ben Harder #BlackLivesMatter (@benharder) April 27, 2021
M-A: Effectiveness of intrapartum fetal surveillance to improve maternal and neonatal outcomes – “none of the newer surveillance methods seem to significantly reduce emergency cesarean deliveries in labor or neonatal morbidity compared with using simple intermittent auscultation of the fetal heart”
28 Apr, 2021 | 08:08h | UTC
RCT: Metformin vs. insulin in gestational diabetes – metformin was associated better glycemic control, lower risk of hypoglycemia, and less maternal weight gain
25 Apr, 2021 | 21:03h | UTCMeDiGes Study. Metformin versus insulin in gestational diabetes: Glycemic control, and obstetrical and perinatal outcomes. Randomized prospective trial. – American Journal of Obstetrics & Gynecology (link to abstract – $ for full-text)
Related: Randomized trial tests metformin in women with type 2 diabetes in pregnancy AND Neonatal, infant, and childhood growth following metformin versus insulin treatment for gestational diabetes: A systematic review and meta-analysis – PLOS Medicine AND Case-Control Study: Metformin Exposure in First Trimester of Pregnancy is Not Associated with Congenital Anomalies
RCT: Induction of Labor at Term with Vaginal Misoprostol or a PGE2 Pessary – little difference in outcomes, the clinical risk-benefit ratio justifies the use of both drugs
25 Apr, 2021 | 20:59h | UTCInduction of Labor at Term With Vaginal Misoprostol or a PGE2 Pessary: a Noninferiority RCT – American Journal of Obstetrics & Gynecology (link to abstract – $ for full-text)
Recommendations on the Management of Maternal Hepatitis B, C and D Infection in Pregnancy
25 Apr, 2021 | 20:44h | UTC
Covid-19: More data on the increased risks to pregnant women and their newborn infants
23 Apr, 2021 | 08:44h | UTCEditorial: COVID-19 in Pregnant Women and Their Newborn Infants
Commentaries: Pregnant women with COVID-19 face high mortality rate – University of Washington School of Medicine AND Covid-19 raises risks for expectant mothers and babies, study says – CNN
Commentary on Twitter
18 country study in >2000 pregnant women with and without #COVID19 shows higher complication and death rates in symptomatic, but not asymptomatic, women with COVID-19. Their babies were at greater risk of neonatal complications, mainly due to preterm birth https://t.co/mRl8OOIMsz
— JAMA Pediatrics (@JAMAPediatrics) April 22, 2021
Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons
22 Apr, 2021 | 08:49h | UTCAudio Interview: Covid-19 Vaccines and Pregnancy — A Conversation with CDC Director Rochelle Walensky – New England Journal of Medicine
Commentaries: No evidence that Pfizer or Moderna vaccines are unsafe during pregnancy, a preliminary study says. – The New York Times AND Preliminary data show no safety concerns for pregnant women receiving COVID-19 vaccines – AAP News AND Messenger RNA COVID vaccines likely safe for pregnant women: Study – ABC News
Maternal, Fetal, and Child Outcomes of Mental Health Treatments in Women: A Systematic Review of Perinatal Pharmacologic Interventions
22 Apr, 2021 | 08:19h | UTCSee also: Final Report AND Evidence Summary
M-A: Progestogens for preventing miscarriage
21 Apr, 2021 | 06:22h | UTCProgestogens for preventing miscarriage: a network meta‐analysis – Cochrane Library
Summary: Are progestogen treatments effective in preventing miscarriage? – Cochrane Library
Related Meta-analysis: Evaluating Progestogens for Preventing Preterm birth International Collaborative (EPPPIC): meta-analysis of individual participant data from randomised controlled trials – The Lancet (link to abstract – $ for full-text)
RCT: Continued versus discontinued oxytocin stimulation in the active phase of labor
16 Apr, 2021 | 06:18h | UTCCommentaries: Study sheds more light on use of oxytocin during labour – The BMJ AND Study Explores Oxytocin Use in Active Phase of Induced Labor – HealthDay
Commentary on Twitter
#BMJInfographic #VisualAbstract Routine discontinuation of oxytocin stimulation in the active phase of labour may lead to a small increase in caesarean section rate but a reduced risk of uterine hyperstimulation and abnormal fetal heart rate patterns https://t.co/LbCxUf1MSx pic.twitter.com/BSQ5rrwQb5
— The BMJ (@bmj_latest) April 15, 2021
Were pregnant women more affected by COVID-19 in the second wave of the pandemic?
16 Apr, 2021 | 06:24h | UTCWere pregnant women more affected by COVID-19 in the second wave of the pandemic? – The Lancet
M-A: Antenatal corticosteroids for impending late preterm (34-36+6 weeks) deliveries
7 Apr, 2021 | 01:22h | UTC
Guideline for elective cesarean section: updated systematic review and procedure‐specific postoperative pain management recommendations
2 Apr, 2021 | 09:09h | UTC
Randomized controlled trial compared three antiretroviral regimens started in pregnant women with HIV
2 Apr, 2021 | 09:15h | UTCCommentary: ART in pregnant women living with HIV – The Lancet
Effects of the COVID-19 pandemic on maternal and perinatal outcomes: a systematic review and meta-analysis
2 Apr, 2021 | 09:23h | UTCCommentaries: Covid-19 led to a global increase in stillbirths, maternal mortality, and depression, review finds – CNN AND COVID-19 pandemic and health-care disruptions: count the most vulnerable – The Lancet Global Health
Commentary on Twitter
NEW—Pregnancy outcomes worsened during the #COVID19 pandemic worldwide, with an increase in maternal deaths, stillbirth, ruptured ectopic pregnancies, and maternal depression.
New review of 40 studies from 17 countries in @LancetGH: https://t.co/GWBohu6b6k pic.twitter.com/4RzgtShYeH
— The Lancet (@TheLancet) April 1, 2021
Obesity in women: anesthetic implications for peri‐operative and peripartum management
2 Apr, 2021 | 09:07h | UTC
Cohort study: Association of spontaneous abortion with all cause and cause specific premature mortality
1 Apr, 2021 | 03:27h | UTCCommentaries: Miscarriage linked to increased risk of early death – The BMJ AND Miscarriage Linked to Higher Risk for Premature Mortality – HealthDay
Commentary on Twitter
Study suggests spontaneous abortion is associated with a greater risk of premature death, particularly from cardiovascular disease. Spontaneous abortion could be an early marker of future health risk in women, including premature death, say the authorshttps://t.co/mA7IrF0J00
— The BMJ (@bmj_latest) March 28, 2021
RCT: Six vs. Twelve Hours of Single Balloon Catheter Placement with Oxytocin Administration for Labor Induction
31 Mar, 2021 | 03:02h | UTCSix vs. Twelve Hours of Single Balloon Catheter Placement with Oxytocin Administration for Labor Induction: A Randomized Controlled Trial – American Journal of Obstetrics & Gynecology (link to abstract – $ for full-text)
The impact of COVID-19 on pregnancy outcomes: a systematic review and meta-analysis
31 Mar, 2021 | 03:27h | UTC