BJOG: An International Journal of Obstetrics and Gynaecology

In many settings, a follow-up clinic visit two weeks after early medical abortion (EMA) is scheduled for a routine ultrasound to confirm that the pregnancy had been terminated. However, ultrasound facilities and the necessary manpower are costly and limit the settings where follow up can be provided.

No abstract text is available yet for this article.

The main finding of the large retrospective cohort study by Marcellin et al. (BJOG xxxx) is the high prevalence of ileocoecal endometriosis (ICE) of 25.6%. In previous surgical series, the reported prevalence of ICE is lower, with rates up to 10.2%. By contrast, the study's interesting finding that ICE is associated with severe deep endometriosis and higher ASRM stages is in line with prior reports indicating that ICE is a marker of advanced disease. This article is protected by copyright. All rights reserved...

OBJECTIVE: To describe the epidemiology of rheumatic heart disease (RHD) in pregnancy in Australia and New Zealand (A&NZ). DESIGN: Prospective population-based study. SETTING: Hospital-based maternity units throughout A&NZ. POPULATION: Pregnant women with RHD with a birth outcome of 20 weeks' gestation or more between January 2013 and December 2014. METHODS: We identified eligible women using the Australasian Maternity Outcomes Surveillance System (AMOSS)...

OBJECTIVE: Unselected population-based BRCA testing provides the opportunity to apply genomics on a population-scale to maximise primary prevention for breast-and-ovarian cancer. We compare long-term outcomes of population-based and family-history (FH)/clinical-criteria-based BRCA testing on psychological health and quality of life. DESIGN: Randomised controlled trial (RCT) (ISRCTN73338115) GCaPPS, with two-arms: (i) population-screening (PS); (ii) FH/clinical-criteria-based testing...

OBJECTIVE: To define the predictive value (PV) of known prognostic factors of fetal infection with cytomegalovirus following maternal primary infection < 14 weeks', at different time points of pregnancy: end of second trimester, following prenatal MRI at 32 weeks', using all ultrasound scans performed in the third trimester (US3rd T). DESIGN: A retrospective study. POPULATION: 62 fetuses infected < 14 weeks'. METHODS: We defined second trimester assessment (STA) as the combination of ultrasound findings <28 weeks' and fetal platelet count at cordocentesis...

OBJECTIVE: To evaluate if the intraoperative human papillomavirus (IOP-HPV) test has the same prognostic value as the HPV test performed at 6 months after treatment of High Grade Squamous Intraepithelial Lesion (HSIL) to predict treatment failure. DESIGN: Prospective cohort study. SETTING: Barcelona, Spain. POPULATION: A cohort of 216 patients diagnosed with HSIL treated with loop electrosurgical excision procedure (LEEP)...

OBJECTIVE: To compare the vaginal microbiota of women living with HIV (WLWH) to the vaginal microbiota of women with recurrent bacterial vaginosis (BV) and healthy women without HIV to determine if there are differences in the vaginal microbiome, what factors influence these differences, and to characterize HIV clinical parameters including viral load and CD4 count in relation to the vaginal microbiome. DESIGN: Observational cohort study. SETTING: Canada...

The Euro-Peristat comparisons "challenge health professionals and policy makers to confront shortcomings in their own countries": a laudable task. However, what to target and how? The suggestions of the Euro-Peristat data presented in this edition highlight reducing Caesarean delivery, fetal and neonatal mortality, and preterm birth (Zeitlin J et al, BJOG xxxx). An operative intervention and three undesired outcomes: are these rates under our control, and if so, how to effect change? This article is protected by copyright...

The first step in preventing preterm birth (PTB) is screening for risk factors and then assessing risk accurately. One of the most important risk factors is a history of spontaneous PTB or PPROM <34 weeks or late miscarriage. Considerable efforts have been made in recent years to identify tests predictive for spontaneous PTB in this high risk population. Cervical length, measured by transvaginal ultrasonography, and quantitative cervicovaginal fetal fibronectin concentrations are currently the best predictive markers for spontaneous PTB in asymptomatic women, mainly because of their high negative predictive values (Honest H et al, Health Technol Assess 2009;13:1-627)...

No abstract text is available yet for this article.

OBJECTIVE: To evaluate enzymatic total serum bile acid quantification as a monitoring strategy for women with intrahepatic cholestasis of pregnancy (ICP) treated with ursodeoxycholic acid (UDCA). DESIGN: Cohort. SETTING: One UK university hospital. POPULATION: 29 ICP cases treated with UDCA. METHODS: Serial samples were collected prospectively throughout gestation. Total serum bile acids were measured enzymatically and individual bile acids by High-Performance Liquid Chromatography-Tandem Mass Spectrometry...

OBJECTIVE: To estimate incidence, trends over time, and risk factors for massive blood transfusions in obstetric patients. A secondary aim was to evaluate transfusion ratios in relation to massive transfusion. DESIGN: Population based cohort. SETTING: Five hospitals, in the Stockholm County, Sweden, from 1990-2011. POPULATION: All women that gave birth in Stockholm county, Sweden, and who received blood transfusions postpartum between 1990 and 2011...

OBJECTIVE: The present study aimed to analyze the Korean National Health Insurance Service (NHIS) cohort data to examine the safety of acupuncture therapy during pregnancy. DESIGN: Retrospective cohort. SETTING: Korea. POPULATION OR SAMPLE: Women with confirmed pregnancy between 2003 and 2012 from the 2002-2013 NHIS sample cohort (n=20 799). METHODS: Women with confirmed pregnancy were identified and divided into acupuncture or control group for comparison of their outcomes...

A recent case series evaluated a potential link between paracetamol use during pregnancy and premature constriction or closure of the fetal ductus arteriosus (Allegaert K. et al. Br J Clin Pharmacol. 2019 Jan; 85(1):245-251). Criteria from the World Health Organization Uppsala Monitoring Centre causality assessment tool were applied and in 15 of 25 cases causality was classified as probable or certain with another 9 cases classified as possible. How should this information be interpreted clinically given that there are no denominators and attributable risk cannot be determined?...

BACKGROUND: For many women, the need for multiple clinical visits is a barrier to medical abortion. OBJECTIVES: We assessed the effectiveness, safety, and acceptability of self-assessment of the outcome of medical abortion completed at home versus routine clinic follow-up after medical abortion. SEARCH STRATEGY: We searched databases such as Medline, Embase, and CENTRAL to find studies published 1991-2018. SELECTION CRITERIA: Eligible studies included women of reproductive age who had undergone a medical abortion that was completed at home...

OBJECTIVE: To characterize the bladder microbiota of continent adult women. DESIGN: Cross-sectional study of adult women who contributed catheterized urine samples, completed validated symptom questionnaires and provided demographic data. SETTING: US academic medical center. POPULATION: Well-characterized continent adult women. METHODS: Participants contributed symptoms questionnaires, demographic data and catheterized urine samples that were analyzed by enhanced urine culture methodology and 16S rRNA gene sequencing...

Rhesus D alloimmunization in pregnancy decreases in prevalence upon adoption of guidelines for the ante- and postpartum use of anti-D (Moise KJ. et al. Obstet Gynecol. 2008:112:164-76). Any procedure or clinical event that induces a risk of direct contact between fetal Rh D positive antigen and a maternal RhD negative immune system may theoretically trigger maternal alloimmunization. This article is protected by copyright. All rights reserved.

In this issue of BJOG, Rodriguez et al. (BJOG xxxx) report results of a retrospective cohort study examining the impact of marijuana use on perinatal outcomes among 1206 young (age 13-22) pregnant women. The study was set in Colorado, a state which legalized medicinal marijuana use in 2000 and recreational use in 2014. Over the past two decades, national and regional policy shifts towards legalization of marijuana correlate with increased use among reproductive age and pregnant women (Brown et al. JAMA 317: 207-209)...

Preterm birth remains a multifactorial, worldwide problem. Though there are multiple established risk factors for preterm birth (e.g., previous preterm birth, short cervix), the association between maternal alcohol consumption and prematurity is less clear, with risk ratios ranging from 0.66 (95% CI 0.52-0.84) to 1.34 (95% CI 1.28-1.41) (Strandberg-Larsen et al. Eur J Epidemiol 2017;32:751-64; Aliyu et al. Eur J Public Health 2010;20:582-87). This article is protected by copyright. All rights reserved.