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 Good results from shoulder dystocia treated in primary midwifery care
Shoulder dystocia is one of the most feared obstetric emergencies, and fear of inadequate treatment is one reason why many women prefer to delivery in hospital. This series of 66 cases occurring under primary midwifery care, 45 at home and 19 in a birthing centre, reports good results. Two infants (3.1%) sustained a transient brachial plexus injury, but there were no long term infant sequelae.Acta Obstet Gynecol Scand 2016; 95:203–209
Editor's comment: Prof. Jim Thornton: Unclear results from UKCTOCS trial
The main results of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS), involving more than 200 000 women were published in the Lancet in December. The primary analysis showed no significant difference in ovarian cancer mortality. Secondary analysis, with prevalent cases excluded, showed a nominally significant reduction in ovarian cancer mortality with multimodal screening, but no difference in overall mortality.
Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trialThe Lancet, December 2015
Selected AJOG Papers
Editor’s comment: Prof. YvesVille: Cerebral Palsy: the changing face of an old enemy
Cerebral palsy (CP) encompasses a heterogeneous group of early-onset, non-progressive, neuromotor disorders that affect the developing fetal or infant brain. CP has become our enemy but also our curse since Little linked this condition to birth asphyxia in the mid-19th century. Freud attributed the disorder to brain injury from various causes, including prenatal events, and emphasised that extended labour was not the exclusive or even principal cause, therefore increasing our responsibility not to say our feeling of guilt. Although our practice has been hugely influenced by this threat over the last 50 years, mainly through an increase in cesarean section rates. An update on the prevalence of cerebral palsy through a systematic review and meta-analysis gauging the prevalence of CP over time has shown that it has remained depressingly and frustratingly stable over the last 10 years at around 2 per 1,000 births. (Oskoui et al, 2013) The main illustration of this catch-22 situation in developed nations is largely explained by an increase in survival of very premature and low-birthweight babies together with higher numbers of multiple births, which often result in preterm births. This has therefore led to a new generation of people affected with CP, probably because of vulnerability of the immature brain, especially in babies with intraparenchymal or intraventricular bleeds or periventricular white-matter abnormalities. The increase in such high-risk situations may contribute to mask teh factors that may contribute to decrease the prevalence of CP, such as the use of antenatal corticosteroids, cooling for term-born asphyxiated infants, and the use of magnesium sulphate...
Alastair H. MacLennan MD, FRANZCOG, Suzanna C. Thompson MBBS, FRACP, Jozef Gecz PhD
American Journal of Obstetrics and Gynecology, Volume 213, Issue 6, December 2015, Pages 779 - 788
Editor’s comment: Prof. Dan Farine: Another meta-analysis that changes dogmas in obstetrics
This is another meta-analysis that changes dogmas in obstetrics. The common wisdom has been that induction of labor increases the risk of cesarean delivery and the risk is higher if the cervix is unripe. This started changing with the post-term trial of Mary Hannah that showed that at 41 weeks there is better outcome with induction of labor. This is the third meta-analysis showing that induction of labor at term and post term does not increase the risk of CS and results in a better outcome for the baby. It has been known for long time that the rate of stillbirth starts increasing at 38 weeks on a weekly basis. This new sets of data allows for an earlier induction of labor without worrying about poor outcome and increased cesareans. The meta-anlysis by Mishanina E et al. in the CMAJ may explain why the new data is different from the old dogma as they show that oxytocin only induction does not offer these benefits (and neither do preterm inductions). This information is even more important as the number of pregnancies in older women is increasing. There is ample data now showing that risk of stillbirths at women that are 40 years and older at 39 weeks is similar to that of younger women at 41 weeks. These women can now be induced at 39 weeks without worrying about the induction per se increasing their CS rate.
Induction of labor at full term in uncomplicated singleton gestations: a systematic review and metaanalysis of randomized controlled trials
Gabriele Saccone MD, Vincenzo Berghella MD
AJOG Volume 213, Issue 5, November 2015, Pages 629–636
Predictive accuracy of changes in transvaginal sonographic cervical length over time for preterm birth: a systematic review and metaanalysis
Agustin Conde-Agudelo MD, MPH, PhD, Roberto Romero MD, DMedSci
American Journal of Obstetrics and Gynecology, Volume 213, Issue 6, December 2015, Pages 789 - 801
Prevention of preterm birth with vaginal progesterone or 17-alpha-hydroxyprogesterone caproate: a critical examination of efficacy and safety
John M. O’Brien MD, David F. Lewis MD, MBA
American Journal of Obstetrics and Gynecology, Volume 214, Issue 1, January 2016, Pages 45 - 56
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...
- James Drife is Emeritus Professor of Obstetrics and Gynaecology at the University of Leeds, UK. He has written widely on...