Pravastatin Versus Placebo in Pregnancies at High Risk of Term Preeclampsia.

Background: Effective screening for term preeclampsia is provided by a combination of maternal factors with measurements of mean arterial pressure, serum placental growth factor, and serum soluble fms-like tyrosine kinase-1 at 35 to 37 weeks of gestation, with a detection rate of ≈75% at a screen-positive rate of 10%. However, there is no known intervention to reduce the incidence of the disease.

Methods: In this multicenter, double-blind, placebo-controlled trial, we randomly assigned 1120 women with singleton pregnancies at high risk of term preeclampsia to receive pravastatin at a dose of 20 mg/d or placebo from 35 to 37 weeks of gestation until delivery or 41 weeks.

Early vaginal progesterone versus placebo in twin pregnancies for the prevention of spontaneous preterm birth: a randomized, double-blind trial.

Background: In women with a singleton pregnancy and sonographic short cervix in midgestation, vaginal administration of progesterone reduces the risk of early preterm birth and improves neonatal outcomes without any demonstrable deleterious effects on childhood neurodevelopment. In women with twin pregnancies, the rate of spontaneous early preterm birth is 10 times higher than that in singletons, and in this respect, all twins are at an increased risk of preterm birth. However, 6 trials in unselected twin pregnancies reported that vaginal administration of progesterone from midgestation had no significant effect on the incidence of early preterm birth.

Medical and Surgical Education Challenges and Innovations in the COVID-19 Era: A Systematic Review.

The aim of this systematic review was to identify the challenges imposed on medical and surgical education by the COVID-19 pandemic, and the proposed innovations enabling the continuation of medical student and resident training. A systematic review on the MEDLINE and EMBASE databases was performed on April 18th, 2020, and yielded 1288 articles. Sixty-one of the included manuscripts were synthesized in a qualitative description focused on two major axes, "challenges" and "innovative solutions", and two minor axes, "mental health" and "medical students in the frontlines".

Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia.

Background: Preterm preeclampsia is an important cause of maternal and perinatal death and complications. It is uncertain whether the intake of low-dose aspirin during pregnancy reduces the risk of preterm preeclampsia.

Methods: In this multicenter, double-blind, placebo-controlled trial, we randomly assigned 1776 women with singleton pregnancies who were at high risk for preterm preeclampsia to receive aspirin, at a dose of 150 mg per day, or placebo from 11 to 14 weeks of gestation until 36 weeks of gestation.

Factors that determine patient satisfaction after surgical treatment of ectopic pregnancy: improving the patient journey!

Objectives: The aim of our study is to identify factors that influence the woman's perception of satisfaction during the process of treatment for this potentially life threatening condition. To evaluate the patient characteristics and factors surrounding the diagnosis and subsequent management of women with ectopic pregnancy and the influence of these on the overall satisfaction rates after discharge from hospital in order to improve quality of care.

Study Design: This is a prospective cohort study undertaken over a period of 4 years (January 2009-December 2012) in a busy early pregnancy unit, in a London university hospital, catering to a multi-ethnic diverse population.

An unusual cause of postmenopausal bleeding.

Background: Non-Hodgkin lymphoma usually presents with lymphadenopathy, fever, night sweats, and weight loss. Postmenopausal vaginal bleeding is a cardinal symptom of carcinoma of the endometrium or cervix but not one of non-Hodgkin lymphoma. Clinical awareness of this unusual mode of presentation is important.

Growing teratoma syndrome of ovary.

Growing teratoma syndrome is an increase of tumor size containing only a mature teratoma component, during or after chemotherapy for germ cell tumors. Mature teratomatous elements are chemoresistant and have to be resected surgically. We describe three patients with malignant immature teratoma treated with chemotherapy and surgical resection.