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:Ten different Caesarean section techniques are equally safe
    Three year follow up of the CORONIS factorial trial comparing single with two layer closure, catgut with polygalactin, exteriorisation or not, peritoneal closure or not and blunt versus sharp abdominal entry, has shown no important differences in any of the predefined outcomes. 

    Caesarean section surgical techniques: 3 year follow-up of the CORONIS fractional, factorial, unmasked, randomised controlled trial

    The CORONIS collaborative group

    The CORONIS collaborative group (2016) Caesarean section surgical techniques: 3 year follow-up of the CORONIS fractional, factorial, unmasked, randomised controlled trial. Lancet Jul 02, 2016, 388; 62-72.
  • Editor’s comment: Prof. Jim Thornton: Induction of labour for suspected macrosomia
    Induction of labour for suspected fetal macrosomia reduces birthweight, fractures and shoulder dystocia. It does not appear to alter the rate of caesarean or instrumental delivery. The trials were too small to estimate the effect of induction on brachial plexus injury.

    Induction of labour at or near term for suspected fetal macrosomia

    Boulvain M et al.

    Cochrane Database Syst Rev. 2016 May 22;(5):CD000938. doi: 10.1002/14651858.CD000938.pub2

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Selected AJOG Papers

Editor’s comment: Prof. Yves Ville: Non-invasive whole fetal genome sequencing : Putting the cart before the horse ?
(Editor's comment relates to the AJOG article below)

The development of next-generation sequencing (NGS) technologies (ie, new high-throughput and massively parallel DNA sequencing technologies) has substantially reduced both the cost and the time required to sequence an entire human genome.  Its application to the human fetus has become a reality that is close to clinical implementation. (Lefkowitz R. et al) It is therefore both critical and urgent to be prepared for a shift in paradigm in prenatal screening and diagnosis.

Editor’s comment: Prof. Dan Farine: Disclosure of possible conflicts and other pitfalls waiting those who publish
(Editor's comment relates to the AJOG article below)

In this interesting paper the major finding is that 68% of physicians submitting a paper to the Society of Gynecological Surgery (SGS) did not properly disclose their full relationship to industry. Interestingly, the way that the under-reporting was found was based on earlier disclosure of these physicians of such a relationship.

Publishing is a way to achieve recognition as an expert and academic promotion. Publications are the major way to disseminate new information and improve medical practice. Individuals may feel pressure to publish for these reasons. The editors and readers want to see the best information published and they want to be sure that biases are optimally eliminated or at least disclosed...

Editor’s comment: Prof. Dan Farine: Acidemia with Normal pH:
(Editor's comment relates to the AJOG article below)

This interesting study looks retrospectively at the rare occurrence of acidemia and/or low base access in babies with normal Apgar scores. The “common sense approach” has been to assume that the test is erroneous as the baby was doing well and ignore it. In Medico-Legal conferences the rationale for pushing for universal cord pH testing has been that it may identify the group of interest for asphyxia (low pH and Apgar scores). According to this approach it was even more interesting to identify the neonates with a normal pH and base excess. These babies may have been exposed to a hostile intra-uterine environment based on history and/or abnormal fetal heart rates and possibly to less than optimal care. However, since they were not acidotic they would not go on to develop cerebral palsy based on the McLennan dogma that was adopted by the major obstetrical societies (FIGO, ACOG, UK guidelines Australian-NZ ones etc.)...

Editor’s comment: Prof. Yves Ville: To know the chance, a chance to know.
(Editor’s comment relates to the 3 AJOG articles below…)

Advanced screening for fetal aneuploidies using fetal DNA in maternal blood represents a major technical breakthrough that is still struggling to find a pragmatic place within the screening algorithms in most countries, after 4 years of clinical use. The wide and sometimes wild dissemination of the test stresses the critical need for the prescribers of the test to understand the difficulties of its interpretation.

Editor’s comment: Prof. Yves Ville: An unsuspected enemy is doubly dangerous (L. Frank Baum)
(Editor’s comment relates to the 3 AJOG articles below: Aubry et al, Khalifeh et al & Saade et al)
Over a third of infant deaths arise from complications related to preterm births, making prematurity the most frequent cause of infant mortality. Health complications are also a lifelong burden of survivors including mental retardation, cerebral palsy, learning and behavioral problems, respiratory problems, vision and hearing loss, but also diabetes, high blood pressure, and heart disease. This inventory has become a classic lament of perinatologists facing the implacable consequences of prematurity.

Trends in prematurity have been either on the rise (1990-2006) or flattening (2006-2013) with medically indicated « late » prematurity as the main adjustment variable. However around 1/25 pregnancies still face unexpected delivery before 33 weeks’ and roughly half of them are primigravidas without anticipated risk factors...

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...

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