Publications by authors named "Coomarasamy A"

Background: Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide. Accurate diagnosis of PPH can prevent adverse outcomes by enabling early treatment.

Objectives: What is the accuracy of methods (index tests) for diagnosing primary PPH (blood loss ≥ 500 mL in the first 24 hours after birth) and severe primary PPH (blood loss ≥ 1000 mL in the first 24 hours after birth) (target conditions) in women giving birth vaginally (participants) compared to weighed blood loss measurement or other objective measurements of blood loss (reference standards)?

Search Methods: We searched CENTRAL, MEDLINE, Embase, Web of Science Core Collection, ClinicalTrials.

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Background: Despite strong evidence-based strategies for prevention and management, global efforts to reduce deaths from postpartum haemorrhage (PPH) have failed, and it remains the leading cause of maternal mortality. We conducted a detailed review of all maternal deaths from 33 facilities in Malawi to identify health system weaknesses leading to deaths from PPH.

Methods: Data were collected regarding every maternal death occurring across all district and central hospitals in Malawi.

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Objective: To examine the association between periconceptual maternal diet and miscarriage risk among women with recurrent miscarriages.

Design: Prospective multicentre cohort study (Tommy's Net).

Setting: Three university hospital research centres in the United Kingdom.

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Introduction: Postpartum haemorrhage (PPH) remains the leading cause of maternal death. Yet there is a lack of clarity around what research is needed to determine what works and how best to deliver proven PPH interventions. This article describes a WHO-led effort to develop a global PPH research agenda for 2023-2030, to reinvigorate research and innovation while avoiding duplication and waste.

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Article Synopsis
  • The study aimed to see if a large randomized controlled trial could effectively evaluate office hysteroscopy (OH) against standard treatment (ST) for retained pregnancy tissue (RPT) after miscarriage, particularly regarding future pregnancy outcomes.
  • Conducted at Birmingham Women's Hospital, the pilot study involved women who opted for non-surgical management of miscarriage and showed a diagnosis RPT in 33.3% of participants after a follow-up ultrasound.
  • Results indicated high participation and satisfaction rates among patients, suggesting that a future larger trial comparing OH and ST for treating RPT is both necessary and feasible.
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Introduction: Postpartum hemorrhage (PPH) remains the leading cause of maternal mortality. A new clinical intervention (E-MOTIVE) holds the potential to improve early PPH detection and management. We aimed to develop and pilot implementation strategies to support uptake of this intervention in Kenya, Nigeria, South Africa, and Tanzania.

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Background: Fetal growth restriction is associated with perinatal morbidity and mortality. Early identification of women having at-risk fetuses can reduce perinatal adverse outcomes.

Objectives: To assess the predictive performance of existing models predicting fetal growth restriction and birthweight, and if needed, to develop and validate new multivariable models using individual participant data.

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Objective: To predict birth weight at various potential gestational ages of delivery based on data routinely available at the first antenatal visit.

Design: Individual participant data meta-analysis.

Data Sources: Individual participant data of four cohorts (237 228 pregnancies) from the International Prediction of Pregnancy Complications (IPPIC) network dataset.

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Article Synopsis
  • This text indicates that there is a correction to the article with the DOI: 10.1371/journal.pgph.0000385.!
  • It implies that there were errors or updates needed in the original document.!
  • The correction is essential for ensuring accuracy and clarity in the published research findings.!
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Timely detection and treatment of postpartum hemorrhage (PPH) are crucial to prevent complications or death. A calibrated blood-collection drape can help provide objective, accurate and early diagnosis of PPH, and a treatment bundle can address delays or inconsistencies in the use of effective interventions. Here we conducted an economic evaluation alongside the E-MOTIVE trial, an international, parallel cluster-randomized trial with a baseline control phase involving 210,132 women undergoing vaginal delivery across 78 secondary-level hospitals in Kenya, Nigeria, South Africa and Tanzania.

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Objective: There are no globally agreed on strategies on early detection and first response management of postpartum haemorrhage (PPH) during and after caesarean birth. Our study aimed to develop an international expert's consensus on evidence-based approaches for early detection and obstetric first response management of PPH intraoperatively and postoperatively in caesarean birth.

Design: Systematic review and three-stage modified Delphi expert consensus.

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The rate of decline in the global burden of avoidable maternal deaths has stagnated and remains an issue of concern in many sub-Saharan Africa countries. As per the most recent evidence, an average maternal mortality ratio (MMR) of 223 deaths per 100,000 live births has been estimated globally, with sub-Saharan Africa's average MMR at 536 per 100,000 live births-more than twice the global average. Despite the high MMR, there is variation in MMR between and within sub-Saharan Africa countries.

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Objective: To perform a network meta-analysis to specify the route of administration that maximises the effectiveness of each of the available prophylactic uterotonics without increasing the risk for side effects. 2.

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Article Synopsis
  • Some women trying to get pregnant with embryo transfers have a hard time, known as recurrent implantation failure (RIF), and doctors are looking for ways to help them.
  • This study looked at whether a special type of medicine, called immunomodulators, could increase the chances of having a baby for women with RIF who were undergoing treatment.
  • The results showed that women who took immunomodulators had a better chance of having a baby compared to those who only received standard treatment, with a live birth rate of 20.9% versus 15.8%.
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  • Pregnant women infected with SARS-CoV-2 face increased risks, including preterm birth and higher rates of stillbirth or neonatal admissions, highlighting ongoing concerns even after the WHO declared an end to the COVID-19 pandemic in May 2023.
  • A systematic review was performed to analyze the prevalence of early pregnancy loss in women with SARS-CoV-2 and compare these results to those of non-infected pregnant women.
  • The review included various studies that reported pregnancy losses before 20 weeks, as well as data on ectopic pregnancies and pregnancy terminations, ensuring a comprehensive examination of the impact of SARS-CoV-2 on early pregnancy outcomes.
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Background: Postpartum haemorrhage (PPH), defined as blood loss of 500 mL or more after childbirth, is the leading cause of maternal mortality worldwide. It is possible to prevent complications of PPH with timely and appropriate detection and management. However, implementing the best methods of PPH prevention, detection and management can be challenging, particularly in low- and middle-income countries.

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Article Synopsis
  • Morphokinetic models, specifically the PREFER and LB models, show better ability to prioritize euploid embryos for transfer compared to traditional embryologist selection.
  • Study data was collected from 1958 biopsied blastocysts across nine IVF clinics in the UK over two years, analyzing various selection methods' effectiveness.
  • Results indicate that the morphokinetic models had higher ranking success for euploid embryos (47% for PREFER) compared to embryologist selection (39%) and arbitrary selection (37%), with significant statistical differences.
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Background: Treatment with vaginal progesterone reduces the risk of miscarriage and preterm birth in selected high-risk women. The hypothesis that vaginal progesterone can reduce the risk of hypertensive disorders of pregnancy (HDP) is unexplored.

Objectives: To summarise the evidence on the effectiveness of vaginal progesterone to reduce the risk of HDP.

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Article Synopsis
  • * Recent big data studies have identified specific gene mutations linked to both sporadic and recurrent miscarriages beyond just embryonic aneuploidy.
  • * The article reviews the genetic factors involved in miscarriage and discusses how to diagnose and prevent genetic causes of both sporadic and recurrent pregnancy loss.
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The physical and psychological impact of miscarriage can be devastating. There are many lifestyle and therapeutic interventions that may prevent a miscarriage. In this review, we have outlined the key areas for health optimization to prevent pregnancy loss, drawing on the most up-to-date evidence available.

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Objective: Maternal sepsis is the third leading cause of maternal mortality globally. WHO and collaborators developed a care bundle called FAST-M (luids, ntibiotics, ource identification and treatment, ransfer and onitoring) for early identification and management of maternal sepsis in low-resource settings. This study aimed to determine feasibility of FAST-M intervention in a low-resource setting in Pakistan.

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Objective: To investigate whether a Bayesian interpretation might help prevent misinterpretation of statistical findings and support authors to differentiate evidence of no effect from statistical uncertainty.

Design: A Bayesian re-analysis to determine posterior probabilities of clinically important effects (e.g.

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Objective: To determine whether the aneuploidy risk score from a morphokinetic ploidy prediction model, Predicting Euploidy for Embryos in Reproductive Medicine (PREFER), is associated with miscarriage and live birth outcomes.

Design: Multicentre cohort study.

Setting: Nine in vitro fertilization clinics in the United Kingdom.

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