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: 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
  • Editor’s comment: Prof. Jim Thornton: Lifestyle programmes for overweight infertile women
    This randomised trial comparing a six month lifestyle intervention programme preceding infertility treatment, with prompt infertility treatment, for women with a BMI of greater than 29, showed no effect on birth rates over two years.

    Randomized Trial of a Lifestyle Program in Obese Infertile Women

    Mutsaerts, MAQ et al.

    N Engl J Med 2016; 374:1942-1953

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Selected AJOG Papers

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...

  • 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

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