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.
Selected EJOG Papers
Comment by the editor: The benefits of episiotomy
The days of routine episiotomy are long gone but debate continues over whether the reaction against it went too far. “Hands off” perineal management is popular among UK midwives, especially less experienced ones. In this French study of 19,442 vaginal births there were 88 cases of severe perineal tears, a rate of only 0.5%. Risk factors included high birthweight and occipito-posterior position. Mediolateral episiotomy reduced the risk, especially with instrumental delivery. This will be no surprise to experienced obstetricians and midwives.
Thomas Schmitz, Corinne Alberti, Béatrice Andriss, Constance Moutafoff, Jean-François Oury, Olivier Sibony
European Journal of Obstetrics & Gynecology and Reproductive Biology, pages 11 - 15
Comment by the editor: Obese women need more fetal anomaly scans
About 20% of pregnant women in the UK are obese. Besides medical complications, obesity causes practical problems, including with ultrasound scanning. Guidelines recommend 30 minutes for an initial anomaly scan and for a first repeat scan. In this study of 1000 women with singleton pregnancies, over 50% of obese women required a second scan and 12.5% needed more than two scans. The figures were unrelated to gestational age. These results are another example of how the obesity epidemic is increasing the burden on obstetric services.
Catherine Hunsley, Tom Farrell
European Journal of Obstetrics & Gynecology and Reproductive Biology, pages 181 - 184
Comment by the editor: Cell-free DNA – the primary screening test for Down syndrome?
Non-invasive prenatal testing (NIPT) using cell-free DNA in maternal plasma has high specificity and sensitivity for trisomy 21. In the Netherlands conventional first-trimester aneuploidy screening will be available to all women from January 2015. This study used a decision-analytic model to examine the costs and outcomes of a possible further change in practice. It concludes that NIPT should be an option for pregnancies at high risk, but using it as the primary screening test will be feasible only if there is a dramatic decrease in cost.
The consequences of implementing non-invasive prenatal testing in Dutch national health care: a cost-effectiveness analysis
Lean Beulen, Janneke P.C. Grutters, Brigitte H. Faas, Ilse Feenstra, John M.G. van Vugt, Mireille N. Bekker
European Journal of Obstetrics & Gynecology and Reproductive Biology, pages 53 - 61