Free access to the latest research
Welcome to the Obstetrics Resource Centre, with free access to the latest research in the field.
All content is independently selected by the Editors, Professor James O. Drife from Leeds, UK, and Professor Jim Thornton from Nottingham. The Obstetrics Resource Centre provides you with original articles, reviews, selected must-reads, lectures and a congress planner.
From the other journals
Editor’s comment: Prof. Jim Thornton: Arabin cerclage pessary does not reduce preterm birth in singletons
A large trial led by Kypros Nicolaides, and published in the New England Journal of Medicine, has shown that among singleton pregnancies where the cervical length has been measured to be reduced on scan, the use of the Arabin cerclage pessary does not reduce the rate of delivery before 34 weeks. No other substantive adverse outcomes were reduced either.
Nicolaides KH, Syngelaki A, Poon LC, Picciarelli G, Tul N, Zamprakou A, Skyfta E, Parra-Cordero M, Palma-Dias R, Rodriguez Calvo JN Engl J Med. 2016 Mar 17;374(11):1044-52. doi: 10.1056/NEJMoa1511014.
Editor’s comment: Prof. Dan Farine: Corticosteroids for late preterm birth – Are you British or American?
The Society of Maternal Fetal Medicine (SMFM) has published new guidelines on administration of corticosteroids for late preterm pregnancies in order to reduce neonatal morbidity and specifically pulmonary complications. These recommendations are based mainly on the large RCT performed in the American MFM Network that was recently published in the NEJM (1). This study was large and properly designed and conducted in some of the better American Tertiary centers. It clearly showed that there was an improved outcome with a reduction of the poor outcomes from 14% to 11%. Interestingly in 60% of cases there was an administration of only one dose and not of the full course which leads to an unanswered question – is a single dose sufficient to achieve these outcomes...
Cynthia Gyamfi-Bannerman, Elizabeth A. Thom, Sean C. Blackwell, Alan T.N. Tita, Uma M. Reddy, George R. Saade, Dwight J. Rouse, David S. McKenna, Erin A.S. Clark, John M. Thorp, Edward K. Chien, Alan M. Peaceman, Ronald S. Gibbs, Geeta K. SwamyNew England Journal of Medicine, 2016; 160204050010006 DOI: 10.1056/NEJMoa1516783
Selected AJOG Papers
Editor’s comment: Prof. Yves Ville: Is the due date becoming overdue ?
(Editor’s comment relates to the 3 AJOG articles below: Gibson et al, Melamed et al & Masoudian et al)
In vitro fertilization using egg donation (ED) is being used increasingly for women requiring assisted reproduction techniques (ART) with a delivery rate per transfer of around 40%. Initially designed to overcome infertility in young women with hypergonadotropic hypogonadism, this technique is now also increasingly used to achieve pregnancy in older women.
Multiple studies have documented that ED pregnancies are associated with a higher incidence of pregnancy-induced hypertension and placental dysfunction, including small for gestational age, and preterm delivery. However, multiple gestations, advanced age, and underlying polycystic ovary syndrome are constant confounding factors for all studies examining the association between assisted reproductive techniques (ARTs) and hypertensive disorders in pregnancy...
A risk of waiting: the weekly incidence of hypertensive disorders and associated maternal and neonatal morbidity in low-risk term pregnancies
Kelly S. Gibson MD, Thaddeus P. Waters MD, Jennifer L. Bailit MD, MPH
American Journal of Obstetrics and Gynecology, Volume 214, Issue 3, March 2016, Pages 389.e1 - 389.e12
Induction of labor before 40 weeks is associated with lower rate of cesarean delivery in women with gestational diabetes mellitus
Nir Melamed MD, Joel G. Ray MD, Michael Geary MD, Daniel Bedard MSc, Cathy Yang MSc, Ann Sprague PhD, Beth Murray-Davis PhD, Jon Barrett MD, Howard Berger MD
American Journal of Obstetrics and Gynecology, Volume 214, Issue 3, March 2016, Pages 364.e1 - 364.e8
Oocyte donation pregnancies and the risk of preeclampsia or gestational hypertension: a systematic review and metaanalysis
Pourya Masoudian BHSc, Ahmed Nasr MD, MSc, Joseph de Nanassy MD, Karen Fung-Kee-Fung MD, MHPE, Shannon A. Bainbridge PhD, Dina El Demellawy MD, PhD
American Journal of Obstetrics and Gynecology, Volume 214, Issue 3, March 2016, Pages 328 - 339
Editor’s comment: Prof. Dan Farine: The twin study
This is a very important study as it complements the initial results of the Twins Birth Study. Both of these studies are likely to reflect a world-wide results of twins delivery as this a rigorously designed RCT looked at patients in a multitude of centers around the world. As opposed to a common belief before the study, that Caesarean delivery is the “easy way out” in twins’ birth (as in many other conditions), these were not the results of this study. Neither the short term results nor the long term ones showed benefit of an elective Caesarean delivery in term or late preterm twins where the first twin is in a vertex presentation. This may be important to the young mother who has to take care of two babies who do not need to be hampered by inconvenience and possible complications of a Caesarean delivery. There is a new keen and justified interest in the long term effect of Caesarean deliveries. There is an impressive set of data correlating Caesarean birth with increased risks of: diabetes, asthma and increased weight. It is important to mention that this association does not necessarily mean causation. In contrast, there is also an alarming data about the rising rates of adhesive placentas (accreta and percreta). These are definitely related to the scar in the uterus. Luckily, the study by Silver from the MFM network in the USA suggested that this risk is increased mainly after 3 Caesarean deliveries.
It is interesting to see that the results of this study could be interpreted in exactly the opposite way. Women who prefer a Caesarean birth for whatever reason (worries about double vaginal births, apprehension of the small risk of having both vaginal and Caesarean deliveries, need to plan delivery time etc.) may be reassured that a caesarean approach does not increase mortality or major neurological deficits. The same may apply to the obstetricians who are very uncomfortable with the delivery of the second twin. In other words this study is good for both the vaginal and CS camps.
Twin Birth Study: 2-year neurodevelopmental follow-up of the randomized trial of planned cesarean or planned vaginal delivery for twin pregnancy
Elizabeth V. Asztalos MD, Mary E. Hannah MD, CM, Eileen K. Hutton PhD, Andrew R. Willan PhD, Alexander C. Allen MD, CM, B. Anthony Armson MD, Amiram Gafni DSc, K.S. Joseph MD, PhD, Arne Ohlsson MD, Susan Ross PhD, J. Johanna Sanchez MIPH, Kathryn Mangoff BSc, Jon F.R. Barrett MB BCh, MD
American Journal of Obstetrics and Gynecology, In Press, Corrected Proof, Available online 29 January 2016, Available online 29 January 2016
About the Editors
- Jim Thornton is Professor of Obstetrics and Gynaecology, at Nottingham University, and deputy director of the Nottingham Clinical Trials Unit...
- Dr Dan Farine is a Professor of Obstetrics & Gynaecology at the University of Toronto. He is cross appointed to...
- Yves Ville is a Professor of Obstetrics and Gynecology at Paris University since 1998 and is head of Obstetrics and...
- T ak Yeung LEUNG is the Chairman of the Department of Obstetrics and Gynaecology of The Chinese University of Hong...
- James Drife is Emeritus Professor of Obstetrics and Gynaecology at the University of Leeds, UK. He has written widely on...