BJOG: An International Journal of Obstetrics and Gynaecology

OBJECTIVE: This study utilized the Dr. Foster Global Comparators database to identify pregnancy complications and associated risk factors that led to severe maternal morbidity during delivery hospitalizations in large university hospitals based in the United States, Australia and England. DESIGN: Retrospective cohort. SETTING: Births in the United States, England and Australia from 2008-2013. SAMPLE: Data from delivery hospitalizations between2008-2013 were examined using the Dr...

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OBJECTIVE: To investigate whether women using intravaginal progesterone suppositories for preterm birth prevention during pregnancy will have lower rates of Group B Streptococcus (GBS) colonisation at term, compared with women receiving intramuscular 17-alpha-hydroxyprogesterone caproate. DESIGN: This was a retrospective observational cohort study of women who were prescribed a progestogen during their pregnancy for preterm birth prevention, and who delivered at term...

OBJECTIVE: To compare severe maternal outcomes (SMOs) from two multi-centre surveys in Nigerian hospitals, and to evaluate how the SMO burden affects quality of secondary and tertiary hospital care. DESIGN: Two facility-based surveys of women experiencing SMO (maternal near-miss or maternal deaths). SETTING: Sixteen secondary and five tertiary facilities in Nigeria [WHO Multi-Country Survey on Maternal and Newborn Health (WHOMCS)] and 42 public tertiary facilities in Nigeria (Nigeria Near-Miss and Maternal Death Survey)...

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Preterm delivery remains the most significant contributor to perinatal mortality and morbidity. Progestogen supplementation is now standard care for preterm birth prevention in women with a singleton gestation and a history of prior spontaneous preterm birth in some countries such as the USA. There is still controversy regarding the type of progesterone to use. The options include weekly intramuscular 17-alpha-hydroxyprogesterone caproate (17-OHP-C) versus daily intra-vaginal progesterone suppository when access to 17-OHP-C is limited ( Berghella V, Society for Maternal-Fetal Medicine Publications Committee...

OBJECTIVE: To assess the predictive value of C-reactive protein (CRP) level for early septic complications after laparoscopic bowel resection for endometriosis. DESIGN: Retrospective study using data prospectively recorded in the CIRENDO database. SETTING: University tertiary referral center. POPULATION: 303 women managed by segmental resection or disc excision for colorectal endometriosis during 40 consecutive months...

OBJECTIVES: To explore whether non - tuberculous mycobacterial (NTM) organisms are associated with for tubal disease leading to infertility. DESIGN: Prospective observational study. SETTING: Teaching hospital. POPULATION: Women with tubal factor infertility. METHODOLOGY: 173 infertile women with tubal disease were investigated for genital tuberculosis, Chlamydia trachomatis and Neisseria gonorrhoea using PCR, culture and histo-pathological examination (HPE)...

Chambers and colleagues (BJOG, 2019, xxxx[d1]) are to be congratulated on producing the first published study of retraction of articles in the field of obstetrics and gynaecology. They report that the number of retracted articles in obstetrics and gynaecology has increased considerably in recent years, with 94% of retractions occurring since 2000 and 77% retracted in the last decade. Similar temporal rises have been seen in all scientific specialities. This article is protected by copyright. All rights reserved...

OBJECTIVE: To identify the most cost-effective policy for detection and management of fetal macrosomia in late-stage pregnancy. DESIGN: Health economic simulation model. SETTING: All English NHS antenatal services. POPULATION: Nulliparous women in the third trimester treated within the UK NHS. METHODS: A health economic simulation model was used to compare long-term maternal-fetal health and cost outcomes for two detection strategies (universal ultrasound scanning at approximately 36 weeks gestational age versus selective ultrasound scanning), combined with three management strategies (planned caesarean section versus induction of labour versus expectant management) of suspected fetal macrosomia...

OBJECTIVE: To investigate the prevalence of life-threatening complications related to pregnancies with abortive outcome and the associated health service events and performance in Nigerian public tertiary hospitals. DESIGN: Secondary analysis of a nationwide cross-sectional study. SETTING: Forty-two tertiary hospitals. POPULATION: Women admitted for pregnancy-related complications. METHODS: All cases of severe maternal outcomes (SMO: maternal near-miss or death) due to abortive pregnancy complications (defined as spontaneous or induced abortion, and ectopic pregnancy) were prospectively identified over 1 year using uniform identification criteria...

OBJECTIVE: To investigate the burden of maternal near-miss and death due to rupture of the gravid uterus, the indicators of quality of care, and avoidable factors associated with care deficiencies for ruptured uterus in Nigerian tertiary hospitals. DESIGN: Secondary analysis of a nationwide cross-sectional study. SETTING: Forty-two tertiary hospitals. POPULATION: Women admitted for pregnancy, childbirth or puerperal complications...

OBJECTIVE: To evaluate the effect of haemostatic sealant compared with bipolar coagulation on ovarian reserve after laparoscopic cystectomy for ovarian endometriomas. DESIGN: Patient-blinded, randomised controlled trial. SETTING: University-affiliated tertiary hospital. POPULATION: Women aged 18 to 40 years with 3-8cm unilateral or bilateral endometriomas. METHODS: 94 patients were randomised to receive haemostasis by the application of haemostatic sealant (n= 47) or standard care (n=47)...

OBJECTIVE: Morbidity of fetuses affected by gastroschisis is mainly due to bowel ischemic and inflammatory processes. Experimental studies on animal models show that clearing amniotic fluid from the digestive secretions by amnioexchange procedures reduces the inflammatory process. We evaluated the benefit of the amnioexchange procedure for fetal gastroschisis in humans. DESIGN: Prospective, interventional, randomized study. SETTING: Eight referral centers for fetal medicine...

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Bougie and colleagues systematically reviewed the current literature on the association between race/ethnicity and endometriosis diagnosis (Bougie et al. BJOG 2019 xxxx). Compared to white women, black women were less likely (OR:0.49, 95% CI:0.29-0.83) (studies=16) and Asian women were more likely to be diagnosed with endometriosis (OR:1.63, 95% CI:1.02-2.58) (studies=10). The data suggested that Hispanic women were less likely to be diagnosed with endometriosis compared to white women, with a similar magnitude of effect as black women, but this finding was not statistically significant (OR:0...

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The systematic review by Endler, et al. (Endler et al. BJOG, 2019 xxxx) provides reassuring evidence from a range of settings that telemedicine provision of medical abortion is safe, effective, and well-liked by patients and providers. Clinical outcomes were found to be similar to those for models of care that involved an in-person visit. The authors note that surgical evacuation rates for telemedicine patients were higher than those reported for services with in-person visits. However, these higher rates were driven by studies in settings where abortion is legally restricted, and patients may be cared for by clinicians with limited experience with medical abortion...