A History of Cesarean Birth as a Risk Factor for Postpartum Hemorrhage Even After Successful Planned Vaginal Birth.

Background: It is unclear if a history of cesarean birth (CB) is a risk factor for postpartum hemorrhage (PPH) even after a successful planned vaginal birth.

Methods: A historical retrospective cohort study from all deliveries (42,456) between 2004 and 2019. Inclusion criteria were as follows: (i) women with only one previous CB; (ii) liveborn cephalic singleton pregnancy and term spontaneous labor; (iii) successful planned vaginal birth; (iv) no operative vaginal delivery; and (v) no history of PPH.

Prevalence and association of placental lesions with obstetrical features and outcome: data from French prospective study.

Purpose: Since the Consensus Statement diffused by the Amsterdam Placental Workshop Group, knowledge of the meaning of placental vascular malperfusion has become essential in the unavoidable analysis of obstetrical history in a patient followed for autoimmune disease or any other maternal comorbidity. We aimed to analyse the prevalence of various placental lesions from a 6-months prospective observational study and to correlate the various placental profiles to obstetrical outcome, maternal diseases and pregnancy treatments. The frequency of foetal vascular malperfusion lesion could be estimated at 8.

Edema associated with low plasma protein level and any gestational hypertension as warning signs of HELLP syndrome.

Because preeclampsia is a multisystem disorder, its definition has recently been revised, including cases with evidence of renal, liver, neurological, or hematological dysfunction. However, the role of edema remains unclear. While the presence of mild edema is common in normal pregnancy, in severe preeclampsia protein transfer from the vascular into the interstitial compartment could lead to low serum protein level and favor the transport of fluid to the interstitial compartment.

Prognosis associated with initial care of increased fasting glucose in early pregnancy: A retrospective study.

Aim: To evaluate whether the initial care of women with fasting plasma glucose (FPG) levels at 5.1-6.9mmol/L before 22 weeks of gestation (WG), termed 'early fasting hyperglycaemia', is associated with fewer adverse outcomes than no initial care.

Use of the EFI score in endometriosis-associated infertility: A cost-effectiveness study.

Background: The management of endometriosis-related infertility is still under debate. The Endometriosis Fertility Index (EFI) score is performant to predict the occurrence of a spontaneous pregnancy following surgery, but was not evaluated in a cost-effectiveness perspective. Our objective was to quantify fertility outcomes, and costs of different care pathways for endometriosis-associated infertility after primary surgery, with a stratification on the EFI score.

Revisiting the management of term breech presentation: a proposal for overcoming some of the controversies.

Background: The debate surrounding the management of term breech presentation has excessively focused on the mode of delivery. Indeed, a steady decline in the rate of vaginal breech delivery has been observed over the last three decades, and the soundness of the vaginal route was seriously challenged at the beginning of the 2000s. However, associations between adverse perinatal outcomes and antenatal risk factors have been observed in foetuses that remain in the breech presentation in late gestation, confirming older data and raising the question of the role of these antenatal risk factors in adverse perinatal outcomes.

[Effects of a policy for reasonable use of oxytocin during spontaneous labor at term].

Objective: To assess the effect of a modified definition of dystocia and of a different timing of interventions during spontaneous labor on the rate of oxytocin use and on its consequences on labor outcome.

Methods: We compared oxytocin use and labor outcome before and after the introduction of a new protocol for the management of spontaneous labor. By protocol, oxytocin use and/or artificial rupture of the membranes was restricted to cases without progress in cervical dilatation for≥1h and/or no progress of fetal descent for≥1h at full dilatation.