Obstetrics & Gynaecology
Moderate anaemia that has not responded by mid-pregnancy was linked to more stillbirths
An Indian trial cohort ties a poor haemoglobin response at 20–24 weeks to stillbirth and early preterm birth. A higher-dose oxytocin protocol was linked to less haemorrhage after vaginal birth, and amniocentesis sorted preterm ruptured membranes into four groups with very different sepsis rates.
In early pre-eclampsia, the drug chart and the urine protein both flag which women are at higher maternal risk
Two expectant-management cohorts point to prognostic signals already in the notes: how often the antihypertensive has been escalated, and how much protein is in the 24-hour collection.
Antibiotics after second-degree tears cut the odds of wound complications by about two-thirds
A Danish trial cohort names who needs closer perineal follow-up; untreated subclinical hypothyroidism mostly corrects itself; and cervicovaginal Ureaplasma tracks with preterm birth without justifying screening.
Eating more egg and peanut in pregnancy does not prevent infant allergy
A 2,137-woman trial settles a common antenatal question, vaping looks no safer than smoking for preterm birth, and a large cohort suggests the suspicion of a big baby drives more intervention than the baby's size does.
Extended-cycle pills match cyclic ones on pregnancy prevention; recovered LV function after peripartum cardiomyopathy does not stop relapse
A WHO-linked review puts continuous and extended combined pills level with 21/7 regimens, a pooled cohort analysis shows peripartum cardiomyopathy relapses whether or not the ventricle recovered, and three trials report on aspirin timing, a perinatal therapy app and intrapartum azithromycin.
Universal aspirin cut severe pre-eclampsia by about a quarter in one high-risk service
A before-and-after cohort of 36,914 deliveries tests aspirin for everyone booking by 16 weeks; supervised exercise lowers gestational diabetes; hip extension at crowning does not spare the perineum; and ACOG widens opportunistic salpingectomy.
Which cut, which estrogen, which bloods
Episiotomy type pulls in opposite directions at an assisted birth; age at menopause survives as a cardiovascular marker where parity does not; and a bolus regimen that halves the work at caesarean.
Mifepristone outperforms levonorgestrel for emergency contraception
A Cochrane review of 87 trials puts mifepristone ahead of levonorgestrel on pregnancies and side effects, at the cost of delayed menses. Plus what parvovirus B19 really costs a pregnancy, and why a small baby at 35 weeks in chronic hypertension should change your surveillance.
Anaemia that has not corrected by 24 weeks is the signal to act on
A secondary analysis of an Indian iron trial ties a poor haemoglobin response to stillbirth; plus consolidated guidance on disease-modifying therapy through pregnancy, the four faces of preterm PROM, and a growth measure that adds nothing to Doppler.
How hard you are pushing the antihypertensives tells you how the pre-eclampsia is going
Two expectant-management papers land on the same day and point the same way: the numbers you already collect — dose escalations, 24-hour protein — carry prognostic information most units are not using. Plus a practical frame for perimenopausal hormone choices, and a fertility trial whose headline is in the wrong place.
Rh-negative in the resus bay, cerclage in the clinic
Two trials of prehospital whole blood found no survival gain — which removes the argument for giving RhD-positive units to anyone who may still be pregnant one day. Plus new ACOG cerclage guidance, a Canadian alcohol-in-pregnancy standard, and what actually predicts a perineal wound breaking down.
Maternal egg and peanut loading does not prevent infant allergy
A 2,137-woman randomised trial finds no allergy protection from eating more eggs and peanuts in pregnancy and lactation; polycystic ovary syndrome is renamed; and term ultrasound for a big baby changes management more than it changes outcomes.
After peripartum cardiomyopathy, a recovered heart lowers the risk of death in the next pregnancy but not the risk of relapse
A meta-analysis of prior peripartum cardiomyopathy closes the edition. Before it: third-trimester anaemia and preterm birth, blood pressure on dolutegravir in pregnancy, and why starting aspirin a week later did not matter.
Vaginal misoprostol outperforms dinoprostone for induction, and severe pre-eclampsia recurs in one in seven
A 44-paper meta-analysis favours misoprostol for vaginal birth within 24 hours; a US cohort of 560,000 puts numbers on recurrence after severe hypertensive disease; universal aspirin, cerclage height and immediate LARC round out the day.
Cut mediolateral, or do not cut at all
A 5,277-woman US cohort splits the episiotomy question in two at operative delivery; a pooled analysis puts numbers on cardiac risk in lupus pregnancy; and liver enzymes earn a place in the eclampsia neurological assessment.
The sleep complaint that is not a hot flush
Insomnia in the menopausal transition has competition: obstructive sleep apnoea, restless legs and periodic limb movement all rise at the same time and none of them answers to oestrogen. Plus fetal brain growth on a changed diet, astaxanthin before oocyte retrieval, and the three numbers that predict survival after laser for twin-twin transfusion.
What we do before pregnancy, and what we do in the third stage
A half-million-birth linkage study puts a number on the obstetric cost of pre-pregnancy uterine surgery; a 156-study meta-analysis argues against screening for genital mycoplasmas; and a quality-improvement series makes the case for 60 units of oxytocin.
Magnesium sulphate still prevents cerebral palsy — and the benefit fades by school age
The updated Cochrane review confirms a number needed to treat of 60 at two years, with no detectable difference by early school age and three times the rate of maternal side effects severe enough to stop the infusion. Plus a time-restricted window for congenital CMV brain injury, what fetal growth restriction predicts in chronic hypertension, earlier menopause and multimorbidity, and updated guidance on MS in pregnancy.
Confirmed fetal parvovirus infection carries a 39% risk of intrauterine death
Pooled across 44 studies, the outcome depends entirely on whether infection is maternal or fetal — and the 2023-24 wave was no worse than earlier ones. Plus rising preterm prelabour rupture in France, a quarter of pregnancies anaemic in an insured US cohort, how closure technique may shape the caesarean scar, and what expert review does to a CIN2 diagnosis.
Scanning for a big baby finds a third of them and changes what you do to all of them
In nearly 22,000 term pregnancies, third-trimester ultrasound picked up 35% of large babies and produced more caesareans and more maternal morbidity without neonatal benefit. Also: preterm rupture of membranes is four conditions, not one, and how to tell a vulvar dermatosis from genitourinary syndrome of menopause.
Most abnormal thyroid tests in early pregnancy correct themselves
In the placebo arms of two treatment trials, 88.7% of women with subclinical hypothyroidism had a normal test later in the same pregnancy; stillbirth risk by body mass index runs in opposite directions depending on pre-pregnancy diabetes; and international guidelines on fetal growth restriction still cannot agree what it is.
Immediate postpartum LARC prevents pregnancies but expels five times as often after vaginal birth
An umbrella review of nine systematic reviews found six-month pregnancy rates far lower with immediate insertion and expulsion risk five times higher after vaginal delivery, ACOG has published a new clinical practice guideline on cervical cerclage, and metformin failed to prevent gestational diabetes while lengthening gestation.
A haemoglobin still below 10.5 g/dL at 20 weeks predicts stillbirth
A secondary analysis of an Indian trial in 4,252 women with moderate iron deficiency anaemia found stillbirth and early preterm birth risk rose progressively as the mid-pregnancy haemoglobin fell below 10.5 g/dL. Plus aspirin works whenever you start it, and PCOS has been renamed.
A haemoglobin still below 10.5 at 20 weeks predicts stillbirth
An Indian trial's secondary analysis shows the response to iron therapy, not just the diagnosis of anaemia, predicts stillbirth and early preterm birth; ACOG issues a new cerclage guideline; and continuous glucose monitoring improves outcomes in gestational diabetes.
Continuous glucose monitoring in gestational diabetes improved control and reduced caesarean, macrosomia and neonatal hypoglycaemia
A meta-analysis of 21 studies and 5,650 pregnancies found CGM lowered mean glucose by 0.24 mmol/L and time above range by 2.19 percentage points, with 8 to 35% reductions in adverse maternal and neonatal outcomes — alongside a 21% increase in medication use.