Browse Complications of Pregnancy Articles by Topic

17P to Prevent Recurrent PTB in Singleton Gestations: The PROLONG Study

In this large, double-blind, placebo-controlled, international trial, pregnant women at risk for preterm birth (PTB) between 16-36 weeks gestational age were randomized to an intramuscular weekly injection of either 17-hydroxyprogesterone caproate (17P) or placebo. There was no difference in rates of PTB or neonatal morbidity between these two groups. In comparison to the Meis trial published in 2003, the findings of the PROLONG trial question the use of intramuscular 17P injection as the cornerstone of PTB prevention.

Adverse Perinatal Outcomes Related to Intrahepatic Cholestasis of Pregnancy

While a diagnosis of intrahepatic cholestasis of pregnancy is associated with an increased risk for stillbirth, preterm birth, and neonatal respiratory issues, consensus on management within the obstetrics community has not been reached.

The Push Is On to Reduce Pregnancy-Related Deaths

Pregnancy-related death can occur during pregnancy, delivery, and even up to one year after. National health experts are outlining ways to reduce maternal deaths in light of new research indicating that about three out of every five such deaths are preventable.

Progesterone: Not a Treatment for Threatened Abortion

Investigators of this well-designed, randomized, controlled trial conclusively demonstrated that progesterone supplementation does not reduce the risk of early pregnancy loss in women who experience first trimester bleeding.

Should Antibiotic Prophylaxis Be Used for Surgical Treatment of Early Pregnancy Loss?

In this randomized, controlled trial of more than 3,000 women in developing countries with incomplete or missed abortion at less than 22 weeks’ gestation, antibiotic prophylaxis prior to uterine evacuation reduced infection rates when a strict definition for pelvic infection was used, but not when a more expanded definition was used.

Multimodal Stepwise Post-Cesarean Pain Control Reduces Opioid Use

These investigators found that the routine use of acetaminophen alone rather than a combination acetaminophen-opioid significantly reduced overall and daily opioid use. In addition, there was no worse effect on overall pain score or length of stay.

Should All Pregnant Women Be Screened for Hepatitis C?

In this cost-effectiveness analysis using Markov modeling, investigators found that universal antenatal screening for hepatitis C was cost-effective, with a mean incremental cost-effectiveness ratio of approximately $3,000 per quality-adjusted life years gained compared to risk-based screening.

Staged Preeclampsia Screening in Early Pregnancy

The use of 150 mg of daily aspirin from 11 to 14 weeks through 36 weeks of gestation reduces the rate of early preeclampsia (PE) in approximately 90% of at-risk pregnancies. In addition, aspirin also provides the benefit of reducing the risk of PE < 37 weeks by about 60% and the length of NICU stay by about 70%, primarily by reducing the number of neonates delivered before 32 weeks. What constitutes a high-risk patient and what quantifies patient-specific risks before PE develops remain to be answered.

The Effect of Preconception Vitamin D Levels on Live Birth and Pregnancy Loss

This secondary analysis of Effects of Aspirin in Gestation and Reproduction trial found that women with sufficient 25-hydroxyvitamin D levels (≥ 30 ng/mL) were more likely to become pregnant and have a live birth than women with insufficient concentrations of vitamin D.

Infertility Therapy Leads to Increased Risk of Severe Maternal Morbidity

Women undergoing infertility treatment, particularly in vitro fertilization, are at higher risk of severe maternal morbidity, but the overall risk remains low.