Routine Ultrasound at 30th-33rd weeks versus 30th-33rd and 35th-37th weeks in Low-Risk Pregnancies: A Randomized Trial.

Introduction: The aim of this study was to evaluate the accuracy of 35-37 weeks' ultrasound for fetal growth restriction (FGR) detection and the impact of 30th-33rd weeks versus 30th-33rd and 35th-37th weeks' ultrasound on perinatal outcomes.

Methods: This was a randomized controlled trial that enrolled 1,061 low-risk pregnant women: 513 in the control group (routine ultrasound performed at 30th-33rd weeks) and 548 in the study group (with an additional ultrasound at 35th-37th weeks). FGR was defined as a fetus with an estimated fetal weight (EFW) below the 10th percentile.

Uterine preservation with Alcides-Pereira's compressive sutures for postpartum uterine atony.

Introduction: Postpartum hemorrhage (PPH) is mostly caused by uterine atony and is the leading cause of maternal death. Hysterectomy may be necessary in severe cases, but uterine compressive sutures are an uterine-sparing alternative. In 2005, Alcides Pereira proposed a technique with serial superficial stiches around the uterus.

Use of external cephalic version in Portuguese public hospitals.

Objective: To evaluate the use of external cephalic version (ECV) in Portuguese public hospitals with maternity services, as well as exploring the main motives for not offering the technique.

Methods: A cross-sectional observational study was conducted involving an online survey with 34 questions, accessed via an email addressed to all Heads of Department of Portuguese state-owned hospitals with maternity services. In centers where the technique was performed, information was requested on success rates, contraindications for the procedure, and practical aspects related to its use.

Placenta Accreta Overlying a Caesarean Section Scar: A 10-Year Experience in a Tertiary-Care Centre in Portugal.

Introduction: Placenta accreta spectrum disorders are among the leading causes of maternal morbidity and mortality and their prevalence is likely to increase in the future. The risk of placenta accreta spectrum disorders is highest in cases of placenta previa overlying a previous cesarean section scar. Few studies have evaluated placenta accreta spectrum disorders in Portugal.

Perceptions of competency with evidence-based medicine among medical students: changes through training and alignment with objective measures.

Aims: To identify whether medical students' self-perception of competence with evidence-based medicine (EBM) increases throughout their senior years of medical training. Furthermore, to identify whether their self-perception aligns with their true competence measured using a validated tool. This investigation also outlines whether students report observation of and participation in the process of EBM in clinical practice.

Outcome of carpal tunnel decompression with pre-surgical diagnosis determined on general practitioner assessment and nerve conduction study.

Background: Accurate diagnosis of carpal tunnel syndrome is key to successful treatment. At our center a treatment pathway was recently established for patients with carpal tunnel syndrome. Within this pathway patients are assessed by their community practitioner.

Transabdominal and transperineal ultrasound vs routine care before instrumental vaginal delivery - A randomized controlled trial.

Introduction: The role of intrapartum ultrasound as an ancillary method to instrumental vaginal delivery is yet to be determined. This study aimed to compare the use of transabdominal and transperineal ultrasound with routine clinical care before performing an instrumental vaginal delivery, regarding the incidence of adverse maternal and neonatal outcomes.

Material And Methods: A randomized controlled trial was conducted between October 2016 and March 2019 in two tertiary care maternity hospitals in Lisbon, Portugal.

Is Vaginal Breech Delivery Still a Safe Option?

Objective:  To determine whether there was any difference in neonatal and maternal outcomes between breech vaginal delivery and cephalic vaginal delivery.

Methods:  A retrospective, case-control study was conducted between January 2015 and December 2017 in a Portuguese hospital. A total of 26 cases of breech vaginal delivery were considered eligible and 52 pregnant women formed the control group.

Management of pregnancy in case of multiple and giant uterine fibroids.

Uterine fibroids are common among women of reproductive age. During the pregnancy, the potential complications of fibroids, although rare, are of frequent clinical concern. Available studies describing management and obstetrical outcomes in pregnant women with giant fibroids are limited.

What electronic information resources do physiotherapists prefer to use to support their CPD?

Background And Purpose: The way health professionals consume that informal professional education is changing. Physiotherapists are relying more on using electronic sources of information, including social media, to answer clinical questions. This study aims to identify the sources of electronic information physiotherapists in New Zealand use within their informal professional education.

Cesarean Section Rate Analysis in a Tertiary Hospital in Portugal According to Robson Ten Group Classification System.

Objective:  The Robson 10 group classification system (RTGCS) is a reproducible, clinically relevant and prospective classification system proposed by the World Health Organization (WHO) as a global standard for assessing, monitoring and comparing cesarean section (CS) rates. The purpose of the present study is to analyze CS rates according to the RTGCS over a 3-year period and to identify the main contributors to this rate.

Methods:  We reviewed data regarding deliveries performed from 2014 up to 2016 in a tertiary hospital in Portugal, and classified all women according to the RTGCS.

Physical exercise at term for enhancing the spontaneous onset of labor: a randomized clinical trial.

Introduction: Physical exercise at term is empirically used as a method of enhancing the spontaneous labor onset. The objective of this study was to evaluate the effect of controlled maternal physical exercise at term as a method of enhancing the spontaneous labor onset.

Materials And Methods: At 38 weeks low-risk pregnant women, with a singleton cephalic fetus and no previous cesarean deliveries were randomly allocated to one of two arms: the experimental group performed 30 min of walking 3 times a week at 4 km/h, and the control group maintained their usual work and household activities.

Effect of simulation-based training on the accuracy of fetal head position determination in labor.

Objectives: The objective of this study was to evaluate the effect of simulation-based training on the accuracy of fetal head position determination by junior residents during the second stage of labour.

Study Design: This prospective study was conducted in a tertiary care university hospital. During an initial period of 12 weeks, 13 junior residents were asked to routinely evaluate fetal head position by digital examination during the second stage of labour, in women with term singletons in cephalic presentation.

A pilot randomized controlled trial of complete bed rest versus activity restriction after preterm premature rupture of the membranes.

Objective: To assess the impact of bed rest on maternal and neonatal outcomes in pregnancies complicated by preterm premature rupture of the membranes (PPROM), enabling proper sample size calculation for a powered randomized controlled trial (RCT).

Study Design: We conducted a pilot unblinded randomized controlled trial with a 1:1 allocation ratio (complete bed rest vs activity restriction groups) on singleton pregnancies complicated by PPROM at 24 + 0-33 + 6 weeks. Maternal and neonatal data were compared between groups with an intent-to-treat analysis.

National-survey for evaluation of the best screening method of late fetal growth restriction in low risk pregnancy: A prospective study.

Objective: To compare knowledge and practices surrounding third trimester screening of fetal growth restriction (FGR) in low risk pregnancies among Portuguese Gynecologists/Obstetricians (GOs) and General Practitioners (GPs). Primary outcome was to compare the proportion of GOs that consider the need of a third trimester ultrasound (estimation of fetal weight) for screening of FGR in low risk pregnancies and the best time to perform it with the corresponding proportion of GPs.

Study Design: We have conducted a prospective, observational cohort study based on application of surveys to GOs and GPs.

Glucose intolerance in the third trimester is not predictive of adverse outcomes.

Objective: To evaluate the incidence of abnormal third trimester oral glucose tolerance tests (OGTT) results in non-diabetic women and to compare the obstetric and neonatal outcomes with those of women with normal OGTT results.

Methods: Women with third trimester singleton pregnancies with negative gestational diabetes test results earlier in their pregnancy were enrolled into an observational prospective study at a tertiary care hospital between June 1, 2014 and September 30, 2017. All underwent an additional 75 g OGTT between 32 and 36 weeks and were classified as having normal or abnormal results.

Robson Classification System Applied to Induction of Labor.

Objective:  Induction of labor (IL) is a common obstetric procedure, but it is questionable whether or not it results in higher cesarean section (CS) rates. The present study aims to evaluate the impact of IL in the overall CS rates and to analyze these rates according to the method of IL employed and to the Robson group in which it was applied.

Methods:  We have conducted a retrospective study including pregnant women whose labor was induced at a tertiary hospital in 2015 and 2016.

Ability of women to self-classify into the Robson ten-group classification system.

Objective: Recent guidelines from WHO and the International Federation of Gynecology and Obstetrics (FIGO) state that the Robson ten-group classification system (TGCS) should be universally applied to pregnant women. Such information might enable women to make an informed decision about the place and mode of delivery. We assessed whether women could self-classify correctly according to the TGCS.

Does physiotherapy prehabilitation improve pre-surgical outcomes and influence patient expectations prior to knee and hip joint arthroplasty?

Introduction: Evidence supporting physiotherapy prior to hip or knee replacement for decreasing pain and improving function pre and post-operatively is equivocal. This observational cohort study used a mixed-methods approach to investigate whether 8 weeks of physiotherapy led exercise and education ('prehabilitation') would change pain and functional outcomes prior to surgery, and if patients' expectations and satisfaction post-surgery were influenced.

Methods: Participants awaiting THR or TKR were recruited (n = 75).

Accuracy of 12-hour urine collection in the diagnosis of pre-eclampsia.

Objective: To evaluate the accuracy of a 12-hour urine collection to diagnose pre-eclampsia and to determine whether time of collection influences the performance of this test.

Methods: A prospective observational study was conducted in a tertiary obstetric center in Portugal between November 1, 2015, and November 30, 2016. Pregnant women (≥20 weeks) admitted for observation with suspected pre-eclampsia were eligible for inclusion.

Impact of maternal weight on the intra-observer and inter-observer reproducibility of fetal ultrasonography measurements in the third trimester.

Objective: To evaluate the effect of maternal weight on the intra- and inter-observer reproducibility of third-trimester ultrasonography fetal measurements.

Methods: The present prospective study, performed at a tertiary hospital, enrolled patients at between 35  weeks and 36  weeks of singleton pregnancies between January 1, 2015, and July 1, 2016. Fetal ultrasonography measurements were evaluated twice by a first observer and a third time by a second observer.

Breech Presentation: Vaginal Versus Cesarean Delivery, Which Intervention Leads to the Best Outcomes?

Introduction: The best route of delivery for the term breech fetus is still controversial. We aim to compare maternal and neonatal outcomes between vaginal and cesarean term breech deliveries.

Material And Methods: Multicentric retrospective cohort study of singleton term breech fetuses delivered vaginally or by elective cesarean section from January 2012 - October 2014.

Mueller-Hillis maneuver and angle of progression: Are they correlated?

Objective:: Mueller-Hillis maneuver (MHM) and angle of progression (AOP) measured by transperineal ultrasound have been used to assess fetal head descent during the second stage of labor. We aimed to assess whether AOP correlates with MHM in the second stage of labor.

Method:: A prospective observational study including women with singleton pregnancy in the second stage of labor was performed.

Applying the Newman-Peacock Prognostic System to a Portuguese Obstetrical Population - A Useful Tool?

Background:  External cephalic version (ECV) is a maneuver that enables the rotation of the non-cephalic fetus to a cephalic presentation. The Newman-Peacock (NP) index, which was proposed by Newman et al. in a study published in 1993, was described as a prediction tool of the success of this procedure; it was validated in a North-American population, and three prognostic groups were identified.