BJOG : An International Journal of Obstetrics and Gynaecology

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Surgical management of Placenta Accreta Spectrum (PAS) is, if anything, wrought with complexity. Placental invasion can be confined and relatively easy to manage or as surgically challenging as a Stage IV ovarian tumor. In the most extensive cases, the placenta is equally capable of encasing not only the ureter, but also the femoral vessels and obturator nerve, but instead of solid tumor, the surgeon is faced with a mixed solid-cystic structure that behaves like a large arteriovenous fistula until the blood supply from the uterine arteries and collaterals from the bladder are controlled...

OBJECTIVE: To describe and compare the characteristics of women with placenta accreta spectrum (PAS) and their pregnancy outcomes according to the presence of placenta praevia and a prior caesarean. DESIGN: Prospective population-based study. SETTING: All 176 maternity hospitals of 8 French regions. POPULATION: 249 women with PAS, from a source population of 520 114 deliveries. METHODS: Women with PAS were classified into two risk-profile groups, with or without the high-risk combination of placenta praevia (or an anterior low-lying placenta) and at least one prior caesarean...

The results of the IMox study, although not surprising, are very much to be welcomed. This high quality, double-blind study provides conclusive evidence that there is essentially no difference in effectiveness between prophylactic intramuscular (i.m.) oxytocin, carbetocin, and oxytocin+ergometrine (Syntometrine®); (van der Nelson et al. BJOG 2020). Blood loss at 500mls, 1000mls and need for blood transfusion were the same in all 3 groups.

OBJECTIVE: Cardiotocography is widely used to assess fetal well-being during labour. The positive predictive value of current clinical algorithms to identify hypoxia-ischaemia is poor. In experimental studies, fetal hypotension is the strongest predictor of hypoxic-ischaemic injury. Cohort studies suggest that deceleration area and deceleration capacity of the fetal heart rate trace correlate with fetal acidaemia, but it is not known if they are indices of fetal arterial hypotension. DESIGN: Prospective, controlled study...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND: Findings about the effect of prophylactic antibiotics in preventing genital tract infection (GTI) associated with surgical procedures used for incomplete abortions are conflicting. Some reported a decrease in infection associated with the use of antibiotic prophylaxis, while others found no significant reduction in GTI. OBJECTIVE: To systematically synthesize the evidence on the effect of prophylactic antibiotics compared to placebo in women undergoing surgical procedures for incomplete abortion...

OBJECTIVE: To evaluate the incidence of pulmonary metastases in the preoperative work-up of patients with primary vulvar squamous cell carcinoma (SCC). DESIGN: Retrospective cohort study SETTING: Tertiary referral center POPULATION: Patients treated for primary vulvar SCC from 2000-2018 METHODS: The preoperative chest imaging of 452 consecutively treated patients was documented with a minimal follow-up period of two years MEAN OUTCOME MEASURES: Incidence of pulmonary metastases, frequency of chest imaging and subsequent coincidental findings RESULTS: In total 80...

BACKGROUND: Pheochromocytoma and paraganglioma (PPGL) in pregnancy, if not diagnosed antepartum, pose a high risk for mother and child. OBJECTIVE: To examine the clinical clues of antepartum and post-partum/post-mortem diagnosis of PPGL. Search strategy Case reports on PPGL in pregnancy published between 01/01/1988 - 30/06/2019 in English, German, Dutch or French Selection criteria Case reports containing a predefined minimum of clinical data on PPGL and pregnancy...

OBJECTIVE: Robson's Ten Group Classification System (TGCS) creates clinically relevant sub-groups for monitoring caesarean birth rates. This study assesses whether this classification can be derived from routine data in Europe and uses it to analyse national caesarean rates. DESIGN: Observational study using routine data SETTING: 27 EU member states plus Iceland, Norway, Switzerland and the UK POPULATION: All births at ≥22 weeks of gestational age in 2015 METHODS: National statistical offices and medical birth registers derived numbers of caesarean births in TGCS groups...

OBJECTIVE: C-section interrupts mother-to-newborn microbial transfer at birth. Beyond the neonatal period, the impact of C-section on offspring gut microbiota and their short chain fatty acids (SCFAs) remains unclear. Here we examine delivery mode (C-section vs. vaginal) with the infant gut microbiota and fecal SCFAs measured 3 and 12 months after birth. DESIGN: Longitudinal study. SETTING: North Carolina. POPULATION: In 2013-2015 we enrolled pregnant women and followed up their offspring for 12 months...

Pre-eclampsia is a nebulous term. Literally meaning 'prior to a seizure in pregnancy', the name of the syndrome does not accurately depict the clinical reality. The disease rarely leads to eclampsia even if untreated, and this is a rare neurological complication. The definition has been equally imprecise; it has been recognised for many years there is a lack of consistency, even in research papers (Chappell et al. BJOG 1999;106(9)983-5). Original definitions were pragmatic, usually based on consensus, and constructed on blood pressure thresholds known to equate to increased perinatal mortality...

OBJECTIVE: To evaluate partial HPV16/18 genotyping as possible biomarker to select women attending HPV-based cervical cancer screening at higher risk to be referred to colposcopy. DESIGN: Population-based cohort study. SETTING: Organized cervical cancer screening programs (Italy). POPULATION: Women with high-risk HPV infection (period: 2015-2019). METHODS: We analyzed the association between partial HPV16/18 genotyping, cytology triage and histologically-confirmed diagnosis of high-grade cervical intraepithelial neoplasia (CIN3+) lesions...

OBJECTIVE: To understand the complexities surrounding unexplained stillbirth for the development and implementation of culturally acceptable interventions to underpin care in Tanzania and Zambia. DESIGN: Mixed-methods. SETTING: Tertiary, secondary and primary care facilities in Mansa, Zambia and Mwanza, Tanzania. SAMPLE: Quantitative; 1997 women giving birth at two tertiary care facilities (one in each country). Qualitative; 48 women and 19 partners from tertiary, secondary and primary care facilities...

OBJECTIVE: To investigate if cancer in pregnancy causes a higher risk of venous thromboembolism (VTE) during pregnancy and postpartum compared to pregnant patients without cancer. DESIGN: A historical prospective cohort study using data from nationwide registries. SETTING AND POPULATION: We assessed all pregnancies in Denmark between January 1, 1977 to December 31, 2017. METHODS: We linked information concerning cancer diagnosis, pregnancy and VTE diagnosis and potential confounders...