Obstetrics

Not quite. The risk of a woman dying in pregnancy or childbirth is now 44% lower than it was in 1990, which is great news, but not as good as was hoped for.  

The first clinical trial of uterus transplantation in the United States has begun at Cleveland Clinic in Ohio.  

A new drive to halve the rate of stillbirths and neonatal and maternal deaths in England by 2030 has been announced by the health secretary, Jeremy Hunt.  

This case illustrates the challenges that may arise with serum hCG measurements in management of ectopic pregnancies.  

Failure to deliver the placenta after a vaginal birth is an uncommon event that can be associated with significant bleeding and even death if left untreated. The retained placenta may be detached from the uterine wall but is trapped so that it is not expelled through the cervix or non-detached as the placenta fails to separate because of placental inhibition of uterine contractions. Conventional management involves spinal or general anaesthesia to enable introducing a hand inside the uterus to manually remove the placenta, which carries risks of infection and from the anaesthetic, and also requires special facilities. The use of uterine relaxing drugs (tocolytics), either alone or with other drugs to stimulate contractions of the uterus (uterotonics), may bring on the delivery of the placenta and avoid the need for this invasive procedure. This review included three trials that randomly assigned 175 women with the placenta remaining undelivered more than 15 minutes after delivery to either a placebo or the tocolytic nitroglycerin. Both groups received oxytocin to stimulate contractions of the uterus. Combined administration of nitroglycerin and oxytocin did not reduce the need for manual removal of placenta, blood loss, nor the incidence of severe postpartum haemorrhage. Nitroglycerin administration did not cause headache but resulted in a mild drop in blood pressure and a related increase in heart rate. Two out of the three trials had low risk of bias but this result needs confirmation in larger trials with adequate sample sizes to verify the role of nitroglycerin and other tocolytic drugs in managing different subtypes of retained placenta. The trials in this review did not specify the type of retained placenta. We have included an explanation of some of the scientific terms that are used in this review in a glossary (see Appendix 1).  

The risk of a woman dying through pregnancy and childbirth has fallen by 44% over the past 25 years, but the world has missed the millennium development goal to cut maternal deaths by 75%, a report from United Nations agencies and the World Bank Group has shown.1  

Maternal mortality has fallen by 44% since 1990, United Nations agencies and the World Bank Group reported today.  

Elective labor induction in first-time mothers with an unfavorable cervix led to a small but statistically insignificant increase in cesarean deliveries, but not everyone is comfortable with the practice.  

Using medications or devices to soften and dilate the cervix can reduce the amount of manual dilation required before the uterus is surgically emptied of a non-viable pregnancy, or miscarriage. The purpose of this cervical ripening is to reduce the possibility of injury to the uterus and cervix and make the procedure easier to perform, although the ripening agents can have side effects.  

To assess the effects of treatments for prevention of scar tissue after surgical treatment for lesions of the womb in women having difficulty becoming pregnant.  

Genetic variations are associated with post-treatment ovarian function in young breast cancer patients receiving cyclophosphamide, new data suggest.  

Preterm birth is when a baby is born at less than 37 weeks' gestation. These babies are generally more ill and are less likely to survive than babies born at term. Preterm babies are also more likely to have some disability, and the earlier the baby is born the more likely they are to have problems. Even short-term postponement of preterm birth can improve outcomes for babies, as this gives time for the mother to be given a steroid injection to help develop the baby's lungs prior to birth. Short-term postponement of preterm birth may also give the chance to transfer the mother, if required, to somewhere where there is more expert care for the baby available.  

Women in their first trimester who have high levels of abdominal fat are at increased risk for diabetes later in pregnancy, a new study suggests.  

Olá, pessoal! Esta é uma música baseada no glorioso castelo Rá-Tim-Bum. Tema - Técnica operatória da Histerectomia Vaginal Pra quem ficou curioso, Paola é mi...  

Does fear of childbirth exert a strong impact on the preference for elective cesarean section?  

We checked this guideline and decided that it should not be updated at this time. For details, see the update decision and the process for deciding if an update is needed.  

This guideline will shortly be checked to see if it needs updating, please register as a stakeholder to be informed about the decision.  

NICE has developed a Medtech Innovation Briefing (MIB) on ZedScan as an adjunct to colposcopy in women with suspected cervical intra epithelial neoplasia.  

A study suggests that hyperandrogenemia doesn't explain why women with type 2 diabetes are at greater cardiovascular disease risk than women without diabetes or men.  

An updated practice bulletin from the American College of Obstetrics and Gynecology affirmed the use of operative vaginal delivery as an alternative to cesarean delivery when appropriate.