Pregnancy and Birth

A commentary on some of the best research in this field published in the past year

When this 32-year-old woman went for an ultrasound at 27-weeks into her pregnancy, a rare anomaly was found. Can you diagnose it?

What is your diagnosis based on these images?

The introduction of liquids and solids within 6 to 8 hours after cesarean delivery improves the return of GI function without increasing the occurrence of GI complications, according to the results of a systematic review and meta-analysis.

Of the available treatments for obstetric cholestasis, one of them is associated with the greatest improvements in the symptom of pruritus. Do you know which one?

This middle-aged woman has a history of dysmenorrhea. What is your diagnosis based on these images?

After minimally invasive laparoscopic surgery, gum chewing has beneficial effects on bowel motility when used as an adjunct treatment in postoperative care, according to the results of a randomized controlled trial.

The common practice of clamping an umbilical cord within a minute of birth to reduce the possibility of maternal hemorrhaging may need to be revised, according to a new paper published in The Cochrane Database of Systematic Reviews. The study authors searched the Cochrane Pregnancy and Childbirth Group’s Trials Register to find 15 trials involving a total of 3911 mother and infant pairs. The risk of bias in the trials was considered by the paper’s authors to be moderate in nature.

Prevention of maternal influenza during pregnancy may reduce the risk of bipolar disorder, suggest new study findings published in JAMA Psychiatry.

The current treatment of mild gestational diabetes mellitus results in fewer cases of preeclampsia, shoulder dystocia, and macrosomia but seems to have no effect on neonatal hypoglycemia or future poor metabolic outcomes, concluded a systematic review and meta-analysis.

After rising steadily for nearly a decade, the rate of cesarean deliveries appears to have stabilized, according to a new report (www.cdc.gov/nchs/data/databriefs/db124.pdf) from the National Center for Health Statistics. New guidelines and policies encouraging longer gestations have led to a trend of cesarean deliveries occurring more frequently at 39 weeks than at 38 weeks.

While long-acting beta2-agonists (LABAs) and low to moderate doses of inhaled corticosteroids for asthma in pregnancy were not associated with an increased prevalence of adverse perinatal outcomes in a recent cohort study, there was a slight trend toward increased prevalence of low birthweight, premature birth, and small for gestational age infants when mothers were exposed to inhaled corticosteroids at high doses.

There is good evidence that iron supplementation during pregnancy can increase maternal hemoglobin levels, decrease the risk of maternal anemia during late pregnancy, and increase birth weight, according to a systematic review and meta-analysis.

A 34-year-old woman came for routine sonographic examination at 28-weeks gestational age, and a shocking fetal anomaly was discovered. Can you identify it?

Pregnancy after bariatric surgery is associated with a reduced risk of having a large-for-gestational-age infant and an increased risk of having a small-for-gestational-age infant, concluded a matched cohort study of singleton deliveries in Denmark.

This is the case of a third trimester pregnancy for which sonography was done. What is your diagnosis based on these images?

Medical treatment and expectant care are acceptable alternatives to routine surgery after a miscarriage, concluded an intervention review conducted by the Cochrane Pregnancy and Childbirth Group.

Compared with vaginal deliveries, cesarean sections may be associated with an increased risk of endometriosis, according to the findings of a large prospective cohort study conducted in Sweden.

Many choose to discontinue antidepressant treatment during attempts to conceive or during pregnancy, in spite of the risks of untreated perinatal depression. Safety profiles of antidepressant use during pregnancy are increasingly being studied, and many women seek alternatives during pregnancy. This article will review several complementary and alternative (CAM) treatments for prenatal unipolar depression: omega-3 fatty acids, folate, St John’s Wort, bright light therapy, massage therapy, and exercise.

What is your diagnosis in this woman who underwent a routine pelvic sonography for non specific complaints?

Pregnant women who are overweight or obese are at increased risk for preterm delivery, according to a population-based cohort study of women in Sweden.

One incision is associated with better outcomes and potential cost savings.