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BJOG: An International Journal of Obstetrics and Gynaecology

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https://www.readbyqxmd.com/read/29791775/vaginal-microbiome-in-early-pregnancy-and-subsequent-risk-of-spontaneous-preterm-birth-a-case-control-study
#1
Negar Tabatabaei, A Murat Eren, Luis B Barreiro, Vania Yotova, Anne Dumaine, Catherine Allard, William D Fraser
OBJECTIVES: To explore differences in vaginal microbiome between preterm and term deliveries. DESIGN: Nested case-control study in 3D cohort. SETTING: Quebec, Canada. SAMPLE: Ninety-four cases with spontaneous preterm birth (17 early (<34 wk) and 77 late (34-36 wk) preterm birth) and 356 controls with term delivery (≥37 wk). METHODS: To assess vaginal microbiome by sequencing the V4 region of 16S ribosomal-RNA (rRNA) gene in swabs self-collected early pregnancy...
May 23, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29791773/vaginal-microbiome-studies-in-pregnancy-must-also-analyse-host-factors
#2
S S Witkin
It seems logical that the composition of the vaginal microbiota would be a significant variable influencing pregnancy outcome. Bacteria that are not part of the normal microbiota can trigger induction of myometrial contractions and premature delivery. Components of the endogenous microbiome may also be capable, under conditions still ill-defined, of interfering with pregnancy progression. This article is protected by copyright. All rights reserved.
May 23, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29790271/correlation-between-neonatal-outcomes-of-twins-depends-on-the-outcome-secondary-analysis-of-twelve-randomised-controlled-trials
#3
Lisa N Yelland, Ewoud Schuit, Javier Zamora, Philippa F Middleton, Arianne C Lim, Anwar H Nassar, Line Rode, Vicente Serra, Elizabeth A Thom, Christophe Vayssière, Ben Wj Mol, Simon Gates
OBJECTIVE: To estimate the magnitude of the correlation between neonatal outcomes of twins and demonstrate how this information can be used in the design of randomised controlled trials (RCTs) in women with twin pregnancies. DESIGN: Secondary analysis of data from 12 RCTs. SETTING: Obstetric care in multiple countries, 2004-2012. POPULATION OR SAMPLE: 4504 twin pairs born to women who participated in RCTs to assess treatments given during pregnancy...
May 22, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29790266/clindamycin-to-reduce-preterm-birth-in-a-low-resource-setting-a-randomised-placebo-controlled-clinical-trial
#4
Mrutyunjaya B Bellad, Matthew K Hoffman, Ashalata A Mallapur, Umesh S Charantimath, Geetanjali M Katageri, Ganachari, Avinash Kavi, Umesh Y Ramdurg, Sheshidhar G Bannale, Amit Revankar, Nancy L Sloan, Bhalachandra Kodkany, Shivaprasad S Goudar, Richard J Derman
OBJECTIVE: To determine if oral Clindamycin reduces the risk of preterm birth in women with abnormal vaginal microflora as evidenced by a vaginal pH ≥5·0. DESIGN: Randomised double-blind placebo controlled trial. SETTING: Rural southern India. POPULATION: Pregnant women with a singleton foetus between 13 0/7 weeks and 20 6/7 weeks. METHODS: Pregnant women were recruited during prenatal visits in Karnataka India from October 2013 to July 2015...
May 22, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29790255/risk-of-major-congenital-malformations-following-first-trimester-exposure-to-vaginal-azoles-used-for-treating-vulvovaginal-candidiasis-a-population-based-retrospective-cohort-study
#5
Reut Rotem, Boris Fishman, Sharon Daniel, Gideon Koren, Eitan Lunenfeld, Amalia Levy
OBJECTIVE: To evaluate the risk for major malformations following first trimester exposure to vaginal azoles. DESIGN: A population based retrospective cohort study of women exposed to vaginal azoles from the first day of the last menstrual period Until the 90th gestational day. SETTING: A combination of four computerized databases: medications, birth, infant hospitalizations and pregnancy terminations. POPULATION: All women who gave birth or undergone a pregnancy termination at Soroka Medical Center, Beer-Sheva, Israel, between 1999 to 2009...
May 22, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29786973/amniotic-fluid-lactic-acid-and-matrix-metalloproteinase-8-levels-at-the-time-of-fetal-surgery-for-a-spine-defect-association-with-subsequent-premature-preterm-rupture-of-membranes
#6
Antonio F Moron, Aikaterini Athanasiou, Mauricio Barbosa, Herbene J Milani, Stephanno G Sarmento, Sergio Cavalheiro, Steven S Witkin
OBJECTIVE: In utero fetal surgery to correct incomplete closure of the spinal cord lessens the extent of permanent damage but is associated with preterm premature rupture of membranes (pPROM). We determined if compounds in amniotic fluid (AF) collected at the time of surgery predicted subsequent development of pPROM. DESIGN: Prospective study. SETTING: Hospitals in Sao Paulo, Brazil. POPULATION: Twenty four consecutive pregnant women at 24-26 weeks gestation seen between February and October 2017 with a singleton pregnancy underwent in utero surgery to correct an open spinal defect in their fetus...
May 22, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29786971/intergenerational-teen-pregnancy-a-population-based-cohort-study
#7
Ning Liu, Simone N Vigod, M Michèle Farrugia, Marcelo L Urquia, Joel G Ray
OBJECTIVE: To estimate the intergenerational association in teenage pregnancy, and whether there is a coupling tendency between a mother and daughter in how their teen pregnancies end, such as an induced abortion (IA) vs. a livebirth. DESIGN: Population-based cohort study. SETTING: Ontario, Canada. POPULATION: 15,097 mothers and their 16,177 daughters. METHODS: Generalized estimating equations generated adjusted odds ratios (aOR) of a daughter experiencing a teen pregnancy in relation to the number of teen pregnancies her mother had...
May 22, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29782696/routine-antenatal-ultrasound-in-low-and-middle-income-countries-first-look-a-cluster-randomized-trial
#8
Robert L Goldenberg, Robert O Nathan, David Swanson, Sarah Saleem, Waseem Mirza, Fabian Esamai, David Muyodi, Ana L Garces, Lester Figueroa, Elwyn Chomba, Melody Chiwala, Musaku Mwenechanya, Antoinette Tshefu, Adrien Lokangako, Victor Lokomba Bolamba, Janet L Moore, Holly Franklin, Jonathan Swanson, Edward A Liechty, Carl L Bose, Nancy F Krebs, K Michael Hambidge, Waldemar A Carlo, Nancy Kanaiza, Farnaz Naqvi, Irma Sayury Pineda, Walter López-Gomez, Dorothy Hamsumonde, Margo S Harrison, Marion Koso-Thomas, Menachem Miodovnik, Dennis D Wallace, Elizabeth M McClure
OBJECTIVE: Ultrasound is widely regarded as an important adjunct to antenatal care (ANC) to guide practice and reduce perinatal mortality. We assessed the impact of ANC ultrasound use at health centers in resource-limited countries. DESIGN: Cluster randomized trial. SETTING: Clusters within five countries (Democratic Republic of Congo, Guatemala, Kenya, Pakistan and Zambia). METHODS: Clusters were randomized to standard ANC or standard care plus two ultrasounds and referral for complications...
May 21, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29782079/the-dipep-diagnosis-of-pe-in-pregnancy-study-an-observational-study-of-the-diagnostic-accuracy-of-clinical-assessment-d-dimer-and-chest-x-ray-for-suspected-pulmonary-embolism-in-pregnancy-and-postpartum
#9
Steve Goodacre, Kimberley Horspool, Catherine Nelson-Piercy, Marian Knight, Neil Shephard, Fiona Lecky, Steven Thomas, Beverley J Hunt, Gordon Fuller
OBJECTIVE: To identify clinical features associated with PE diagnosis and determine the accuracy of decision rules and D-dimer for diagnosing suspected PE in pregnant/postpartum women. DESIGN: Observational cohort study augmented with additional cases. SETTING: Emergency departments and maternity units at eleven prospectively recruiting sites and maternity units in the United Kingdom Obstetric Surveillance System (UKOSS). POPULATION: 324 pregnant/postpartum women with suspected PE and 198 pregnant/postpartum women with diagnosed PE...
May 21, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29782075/the-mediating-effects-of-gestational-diabetes-on-fetal-growth-and-adiposity-in-women-who-are-overweight-and-obese-secondary-analysis-of-the-limit-randomised-trial
#10
Amanda J Poprzeczny, Jennie Louise, Andrea R Deussen, Jodie M Dodd
OBJECTIVE: to describe the mediating effect of maternal gestational diabetes on fetal biometry and adiposity measures among overweight or obese pregnant women. DESIGN: Secondary analysis of the LIMIT randomised trial. SETTING: Public hospitals, metropolitan Adelaide, South Australia. POPULATION: Pregnant women with body mass index (BMI) ≥25 kg/m2 , and singleton gestation. METHODS: Fetal ultrasound measures at 36 weeks' gestation and baseline BMI from women randomised to the LIMIT trial Standard Care group (n = 912 women) were used to conduct causal mediation analyses using regression-based methods...
May 21, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29782065/foley-catheter-vs-oral-misoprostol-to-induce-labour-among-hypertensive-women-in-india-a-cost-consequence-analysis-alongside-a-clinical-trial
#11
Simon Leigh, Paul Granby, Alan Haycox, Shuchita Mundle, Hillary Bracken, Vaishali Khedikar, Jayashree Mulik, Brian Faragher, Thomas Easterling, Mark A Turner, Zarko Alfirevic, Beverly Winikoff, Andrew D Weeks
OBJECTIVE: To determine the effectiveness and economic impact of two methods for induction of labour in hypertensive women, in low-resource settings. DESIGN: Cost-consequence analysis of a previously reported multi-centre, parallel, open-label randomized trial. SETTING & POPULATION: 602 women with a live fetus, aged>18 years requiring delivery for pre-eclampsia or hypertension, in two public hospitals in Nagpur, India. METHODS: We performed a formal economic evaluation alongside the INFORM clinical trial...
May 21, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29782064/accuracy-of-p57-kip-2-compared-with-genotyping-to-diagnose-complete-hydatidiform-mole-a-systematic-review-and-meta-analysis
#12
José Mauro Madi, Antonio Braga, Machline Paim Paganella, Isnard Elman Litvin, Eliana Márcia Wendland
BACK GROUND: Distinguishing hydatidiform moles (HMs) from non-molar specimens and the sub-classification of HM are important because complete hydatidiform mole (CHM) is associated with an increased risk of development of gestational trophoblastic neoplasia. However, diagnosis based solely on morphology has poor interobserver reproducibility. Recent studies have demonstrated that the use of p57KIP 2 immunostaining improves diagnostic accuracy for CHM. OBJECTIVES: To evaluate the accuracy of p57KIP 2 immunostaining compared with molecular genotyping for the diagnosis of CHM...
May 21, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29775999/who-recommendations-dollars-and-sense
#13
Julian Robinson
In 2016 the World Health organization (WHO) outlined its vision for high quality care for all pregnant women and their newborns (WHO recommendations on antenatal care for a positive pregnancy experience. Geneva, Switzerland: World Health Organization; 2016 pregnancy-experience/en/. In this edition of BJOG it has now updated these recommendations emphasizing the importance of a positive experience during childbirth. Respectful Maternity Care (RMC) is central to this revision. This article is protected by copyright...
May 18, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29772104/transgender-health-research-must-serve-transgender-people
#14
E Kale Edmiston
Transgender health research is experiencing growing pains. More transgender people have been able to access careers as health professionals or researchers in recent years. Transgender community advocates and professionals have pushed the field forward. The literature has shifted from a pathology model to a minority stress model of health disparity. This article is protected by copyright. All rights reserved.
May 17, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29770557/developing-a-set-of-consensus-indicators-to-support-maternity-service-quality-improvement-using-core-outcome-set-methodology-including-a-delphi-process
#15
Kathryn J Bunch, Benjamin Allin, Matthew Jolly, Tom Hardie, Marian Knight
OBJECTIVE: To develop a core metric set to monitor the quality of maternity care. DESIGN: Delphi process followed by a face-to-face consensus meeting. SETTING: English Maternity units. POPULATION: Three representative expert panels: service designers, providers and users. MAIN OUTCOME MEASURES: Maternity care metrics judged important by participants. METHODS: Participants were asked to complete a two phase Delphi process, scoring metrics from existing local maternity dashboards...
May 16, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29757476/limitations-of-treating-pregnant-women-based-solely-on-vaginal-ph
#16
S S Witkin
It has been widely assumed that a vaginal pH >5.0 in pregnant women indicates the presence of an abnormal vaginal microbiome that increases risk of a preterm delivery. Bellard et al. (BJOG 2018;xx), hypothesized that a single 5 day treatment with Clindamycin would restore the vaginal pH to < 4.5 by selectively eliminating the "harmful" bacteria, and, consequently, reduce the rate of preterm birth in treated women. This article is protected by copyright. All rights reserved.
May 14, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29740927/are-singleton-pregnancies-after-assisted-reproduction-technology-art-associated-with-a-higher-risk-of-placental-anomalies-compared-with-non-art-singleton-pregnancies-a-systematic-review-and-meta-analysis
#17
REVIEW
B G Vermey, A Buchanan, G M Chambers, E M Kolibianakis, J Bosdou, M G Chapman, C A Venetis
BACKGROUND: Placental anomalies (placenta praevia, placental abruption, morbidly adherent placenta and cord insertion anomalies) are associated with maternal and fetal morbidity and mortality. It has been suggested these might be more prevalent in pregnancies after assisted reproduction technology (ART). OBJECTIVES: To determine whether ART singleton pregnancies are associated with an increased risk of placental anomalies compared with non-ART singleton pregnancies...
May 8, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29729217/improving-care-for-women-with-obstetric-fistula-new-who-recommendation-on-duration-of-bladder-catheterization-after-the-surgical-repair-of-a-simple-obstetric-urinary-fistula
#18
Mariana Widmer, Özge Tunçalp, Maria Regina Torloni, Olufemi T Oladapo, Maurice Bucagu, A Metin Gülmezoglu
Under the Sustainable Development Goals (SDGs) and universal health coverage, the "survive, thrive, transform" agenda moves beyond reducing mortality and focuses on the importance of maternal morbidity.(1 ) An obstetric fistula, one of the most devastating types of maternal morbidity, is usually caused by injury during childbirth from prolonged or obstructed labour. The prolonged compression of the fetal head against the pelvic bones can cause ischaemic necrosis of parts of the bladder, urethra or vagina, resulting in an abnormal opening between a woman's genital tract and her urinary tract that leads to the continuous flow of urine through the vagina...
May 5, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29729066/exploring-the-limits-of-conscience
#19
Robert McMillen
Dr John Thorp presents the clinical conundrum of working in an establishment where his views on abortion, based on his interpretation of Hippocratic and Catholic ethical codes, were not in kilter with those of his department. Others interpret Hippocratic and Christian ethics differently. As Thorp concedes, the oath was not uncontested even in Hippocrates' day, with most Greek thinkers commending abortion, at least prior to viability (US Supreme Court. Roe v. Wade, 410 U.S. 113 1973 Section VI). Perhaps Hippocrates was against inducing abortion, in 500 BC, because of the harm it would do the mother?...
May 4, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29729059/conscience-and-abortion
#20
J O Drife
Doctors, like everyone else, must listen to their consciences. Those who provide abortion are motivated by compassion. Our conscience will not let us turn away from women in distress. Many of us had a religious upbringing. If we had decided at the start of our training never to talk to these patients, we might never have developed a conscience about them. This article is protected by copyright. All rights reserved.
May 4, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
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